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JOURNAL ARTICLE
Nicole Del Gaudio, Susana Ferrao Santos, Christian Raftopoulos
(1) Background: Hemispherotomy is the generally accepted treatment for hemispheric drug-resistant epilepsy (DRE). Lateral or vertical approaches are performed according to the surgeon's preference. Multiple technical variations have been proposed since Delalande first described his vertical technique. We propose a sub-insular variation of the vertical parasagittal hemispherotomy (VPH) and describe our case series of patients operated on using this procedure. (2) Methods: Data from a continuous series of patients with hemispheric DRE who were operated on by the senior author (CR) using the modified sub-insular VPH technique were analyzed retrospectively...
September 30, 2023: Brain Sciences
#22
JOURNAL ARTICLE
Intraoperative motor-evoked potential with tetanic stimulation changes pre- and post-hemispherotomy.
Ryota Sasaki, Kentaro Tamura, Tsunenori Takatani, Young-Soo Park, Ichiro Nakagawa
BACKGROUND: Careful examination of motor-evoked potential (MEP) findings is critical to the safety of intraoperative neuromonitoring during neurosurgery. We reviewed the intraoperative MEP findings in a pediatric patient who had undergone hemispherotomy for refractory epilepsy. CASE DESCRIPTION: The patient was a 4-year-and-2-month-old boy with extensive right cerebral hemisphere, drug-resistant epilepsy, left upper and lower extremity paralysis, and cognitive impairment...
October 3, 2023: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
#23
JOURNAL ARTICLE
Nilesh S Kurwale, Deepa Bapat, Sujit A Jagtap, Sandeep B Patil, Vivek Jain, Aniruddha Joshi, Yogeshwari Deshmukh, Sujit Nilegaonkar, Sonal Chitnis, Zubin Shah, Prasanthi Aripirala
INTRODUCTION: Present study attempted to analyze seizure freedom and detailed functional outcomes after functional hemispherotomy and utility of hemispherotomy outcome prediction scale (HOPS) scores in predicting outcomes. METHODS: Patients who underwent functional hemispherotomy were analyzed for clinical presentation, neuroimaging, seizure outcomes, and functional outcomes. RESULTS: A total of 76 procedures were performed on 69 patients...
February 2024: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
#24
JOURNAL ARTICLE
Nisha Shenoy, Siddharth Srinivasan, Girish Menon, Radhakrishnan Kurupath
OBJECTIVES: The objectives of this study were to share our initial experience with epilepsy surgery and provide an overview on the surgical treatments of epilepsies. MATERIALS AND METHODS: This was a retrospective analysis of the demographics and clinical and investigative features of patients who underwent epilepsy surgery between January 2016 and August 2021. Postoperative seizure outcome was categorized according to modified Engel's classification, and the minimum period of follow-up was 1 year...
2023: Journal of Neurosciences in Rural Practice
#25
JOURNAL ARTICLE
Daiana R Pur, Gayathri K Sivakumar, Lulu L C D Bursztyn, Yiannis Iordanous, Sandrine de Ribaupierre
BACKGROUND: Children undergoing hemispheric surgery for intractable seizures are susceptible to visual complications including strabismus. This systematic review aims to investigate the rates and characteristics of strabismus development after hemispheric surgery and evaluate clinical implications for ophthalmologic care. METHODS: A systematic search of MEDLINE, EMBASE, Cochrane, PsychINFO, and Web of Science databases was performed from database inception to May 2022...
August 25, 2023: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
#26
JOURNAL ARTICLE
D Chiarello, G Tumminelli, F Sandrin, C Vilasi, L Castana, G Lo Russo, A Liava, S Francione
INTRODUCTION: Only a few studies have focused on tailored resection in post-stroke epilepsy, in which hemispherectomy and hemispherotomy are the most recognized treatments. CASE DESCRIPTION: We describe the case of a patient with drug-resistant, presumed perinatal, post-stroke epilepsy and moderate right hemiparesis. The seizures were stereotyped, both spontaneous and induced by sudden noises and somatosensory stimuli. Considering the discordant anatomic-electro-clinical data - left perisylvian malacic lesion with electrical onset over the left mesial fronto-central leads - and the patient's functional preservation, SEEG was performed...
2023: Epilepsy & behavior reports
#27
JOURNAL ARTICLE
Brenda Cristina Nava, Ursula Thome Costa, Ana Paula Andrade Hamad, Camila Araujo Bernardino Garcia, Americo Ceiki Sakamoto, Davi Casale Aragon, Helio Rubens Machado, Marcelo Volpon Santos
OBJECTIVE: Rasmussen Encephalitis (RE) is a rare inflammatory neurodegenerative disease associated with refractory seizures, hemiparesis, and cognitive deterioration, due to lateralized cortical atrophy. Hemispheric surgery (hemispherotomy) is the mainstay of treatment, but its unavoidable motor deficits and lack of long-term data regarding seizure outcomes can make patients and families apprehensive to undergo this procedure. The present study aimed at analyzing the results of surgical treatment for RE from a motor and epilepsy standpoint, and mitigate such concerns...
August 17, 2023: Epileptic Disorders: International Epilepsy Journal with Videotape
#28
REVIEW
Veronica Cabreira, Daniel Ferreira, Cláudia Melo, Joana Rebelo, Jacinta Fonseca, Raquel Sousa, Mafalda Sampaio
Anti-Hu antibodies are associated with autoimmune syndromes, mainly limbic encephalitis, encephalomyelitis, and painful sensory polyneuropathy (Denny-Brown). We report the case of a 15-year-old boy presenting with epilepsia partialis continua (EPC) found to have a right middle frontal gyrus brain lesion without atrophy or contralateral involvement. After partial resection, neuropathology revealed neuronal loss, reactive gliosis and astrocytosis, and perivascular mononuclear inflammatory infiltrate and features of neuronophagia resembling Rasmussen encephalitis...
October 17, 2023: Neurology
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MULTICENTER STUDY
Konstantin L Makridis, Kerstin Alexandra Klotz, Georgia Ramantani, Lena-Luise Becker, Victoria San Antonio-Arce, Steffen Syrbe, Kathrin Wagner, Mukesch Johannes Shah, Ulrich-Wilhelm Thomale, Anna Tietze, Christian E Elger, Ingo Borggraefe, Angela M Kaindl
Although epilepsy surgery is the only curative therapeutic approach for lesional drug-resistant epilepsy (DRE), there is reluctance to operate on infants due to a fear of complications. A recent meta-analysis showed that epilepsy surgery in the first 6 months of life can achieve seizure control in about two thirds of children. However, robust data on surgical complications and postoperative cognitive development are lacking. We performed a retrospective multicenter study of infants who underwent epilepsy surgery in the first 6 months of life...
September 2023: Epilepsia Open
#30
JOURNAL ARTICLE
Alexander G Weil, Evan Dimentberg, Evan Lewis, George M Ibrahim, Olivia Kola, Chi-Hong Tseng, Jia-Shu Chen, Kao-Min Lin, Li-Xin Cai, Qing-Zhu Liu, Jiu-Luan Lin, Wen-Jing Zhou, Gary W Mathern, Matthew D Smyth, Brent R O'Neill, Roy Dudley, John Ragheb, Sanjiv Bhatia, Daniel Delev, Georgia Ramantani, Josef Zentner, Anthony C Wang, Christian Dorfer, Martha Feucht, Thomas Czech, Robert J Bollo, Galymzhan Issabekov, Hongwei Zhu, Mary Connolly, Paul Steinbok, Jian-Guo Zhang, Kai Zhang, Eveline Teresa Hidalgo, Howard L Weiner, Lily Wong-Kisiel, Samuel Lapalme-Remis, Manjari Tripathi, P Sarat Chandra, Walter Hader, Feng-Peng Wang, Yi Yao, Pierre Olivier Champagne, Tristan Brunette-Clément, Qiang Guo, Shao-Chun Li, Marcelo Budke, Maria Angeles Pérez-Jiménez, Christian Raftopoulos, Patrice Finet, Pauline Michel, Karl Schaller, Martin N Stienen, Valentina Baro, Christian Cantillano Malone, Juan Pociecha, Noelia Chamorro, Valeria L Muro, Marec von Lehe, Silvia Vieker, Chima Oluigbo, William D Gaillard, Mashael Al Khateeb, Faisal Al Otaibi, Niklaus Krayenbühl, Jeffrey Bolton, Phillip L Pearl, Aria Fallah
OBJECTIVES: Although hemispheric surgeries are among the most effective procedures for drug-resistant epilepsy (DRE) in the pediatric population, a large variability in outcomes remains. Identifying ideal hemispherectomy candidates is imperative to maximize the potential for seizure freedom. The objective was to develop an online, freely-accesible tool that accurately predicts the probability of seizure freedom for any patient at 1-, 2-, and 5-years post-hemispherectomy to provide clinicians accessible and reliable prognostic information to complement clinical judgement...
June 22, 2023: Epilepsia
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JOURNAL ARTICLE
Lisa F Akiyama, Emma A Roberts, Hillary A Shurtleff, Dwight Barry, Russell P Saneto, Edward J Novotny, Christopher C Young, Molly H Warner, Jason S Hauptman, Jeffrey G Ojemann, Ahmad Marashly
OBJECTIVE: Epilepsy surgery remains one of the most underutilized procedures in epilepsy despite its proven superiority to other available therapies. This underutilization is greater in patients in whom initial surgery fails. This case series examined the clinical characteristics, reasons for initial surgery failure, and outcomes in a cohort of patients who underwent hemispherectomy following unsuccessful smaller resections for intractable epilepsy (subhemispheric group [SHG]) and compared them to those of a cohort of patients who underwent hemispherectomy as the first surgery (hemispheric group [HG])...
June 2, 2023: Journal of Neurosurgery. Pediatrics
#32
JOURNAL ARTICLE
Alessandro De Benedictis, Alessandra Marasi, Maria Camilla Rossi-Espagnet, Antonio Napolitano, Chiara Parrillo, Donatella Fracassi, Giulia Baldassari, Luca Borro, Antonella Bua, Luca de Palma, Concetta Luisi, Chiara Pepi, Alessandra Savioli, Davide Luglietto, Carlo E Marras
Vertical hemispherotomy is an effective treatment for many drug-resistant encephalopathies with unilateral involvement. One of the main factors influencing positive surgical results and long-term seizure freedom is the quality of disconnection. For this reason, perfect anatomical awareness is mandatory during each step of the procedure. Although previous groups attempted to reproduce the surgical anatomy through schematic representations, cadaveric dissections, and intraoperative photographs and videos, a comprehensive understanding of the approach may still be difficult, especially for less experienced neurosurgeons...
May 31, 2023: Journal of Clinical Medicine
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JOURNAL ARTICLE
Fatima Jaafar, Makram Obeid, Ahmad Beydoun
BACKGROUND: Rasmussen encephalitis (RE) is a rare progressive presumed autoimmune disorder characterized by pharmacoresistant epilepsy and progressive motor and cognitive deterioration. Despite immunomodulation, more than half of the patients with RE ultimately require functional hemispherotomy. In this study, we evaluated the potential beneficial effects of early initiation of immunomodulation in slowing disease progression and preventing the need for surgical interventions. METHODS: A retrospective chart review over a 10-year period was conducted at the American University of Beirut Medical Center to identify patients with RE...
August 2023: Pediatric Neurology
#34
JOURNAL ARTICLE
Jia-Shu Chen, William B Harris, Katherine J Wu, H Westley Phillips, Chi-Hong Tseng, Alexander G Weil, Aria Fallah
BACKGROUND AND OBJECTIVES: Hemispheric surgery effectively treats unihemispheric pediatric drug-resistant epilepsy (DRE) by resecting and/or disconnecting the epileptic hemisphere. Modifications to the original anatomic hemispherectomy have generated multiple functionally equivalent, disconnective techniques for performing hemispheric surgery, termed functional hemispherotomy. While a myriad of hemispherotomy variants exist, all of them can be categorized according to the anatomic plane they are performed in, which includes vertical approaches at or near the interhemispheric fissure and lateral approaches at or near the Sylvian fissure...
July 25, 2023: Neurology
#35
JOURNAL ARTICLE
Jonathan Roth, Itzhak Fried, Shlomi Constantini, Uri Kramer, Ido Strauss, Shimrit Uliel-Sibony
INTRODUCTION: Drug-resistant epilepsy in children is associated with morbidity, developmental regression and mortality. Over recent years, there is an increase in awareness regarding the role of surgery in the treatment of refractory epilepsy, both in the diagnostic phase and for treatment, reducing the number and magnitude of seizures. Technological advancements have enabled a minimalization of surgery, with reduction in surgical associated morbidity. METHODS: In this retrospective study, we review our experience with cranial surgery for epilepsy between the years 2011-2020...
April 2023: Harefuah
#36
JOURNAL ARTICLE
Thilo Kalbhenn, Thomas Cloppenborg, Friedrich G Woermann, Anne Hagemann, Tilman Polster, Roland Coras, Ingmar Blümcke, Christian G Bien, Matthias Simon
OBJECTIVE: Completeness as a predictor of seizure freedom is broadly accepted in epilepsy surgery. We focused on the requirements for a complete hemispherotomy and hypothesized that the disconnection of the insula contributes to a favorable postoperative seizure outcome. We analyzed surgical and non-surgical predictors influencing long-term seizure outcome before and after a modification of our hemispherotomy technique. METHODS: We retrospectively studied surgical procedures, electro-clinical parameters, MRI results, and follow-up data in all children who had undergone hemispherotomy between 2001 and 2018 at our institution...
April 28, 2023: Epilepsia
#37
JOURNAL ARTICLE
Katarina Pavičić Klancir, Dubravko Habek, Vlasta Đuranović, Ana Tripalo Batoš, Sanja Pejić Roško, Milan Stanojević
We represent the case of a premature twin neonate born from uncomplicated pregnancy who developed seizures at the age of 24 h. Two-dimensional ultrasound and magnetic resonance imaging revealed left-sided hemimegalencephaly. Further extensive diagnostic evaluation revealed a diagnosis of Ohtahara syndrome. Resistance of the seizures to antiepileptic therapy led to hemispherotomy that was performed at the age of 10 months. Our patient is now a 4-year-old child, walking, eating without a nasogastric tube, still with right hemiparesis and lateral strabismus but without seizures...
April 18, 2023: Wiener Medizinische Wochenschrift
#38
JOURNAL ARTICLE
Davide Giampiccolo, Lawrence P Binding, Lorenzo Caciagli, Roman Rodionov, Chris Foulon, Jane de Tisi, Alejandro Granados, Roisin Finn, Debayan Dasgupta, Fenglai Xiao, Beate Diehl, Emma Torzillo, Jan Van Dijk, Peter N Taylor, Matthias Koepp, Andrew W McEvoy, Sallie Baxendale, Fahmida Chowdhury, John S Duncan, Anna Miserocchi
Around 50% of patients undergoing frontal lobe surgery for focal drug-resistant epilepsy become seizure free post-operatively; however, only about 30% of patients remain seizure free in the long-term. Early seizure recurrence is likely to be caused by partial resection of the epileptogenic lesion, whilst delayed seizure recurrence can occur even if the epileptogenic lesion has been completely excised. This suggests a coexistent epileptogenic network facilitating ictogenesis in close or distant dormant epileptic foci...
June 1, 2023: Brain
#39
JOURNAL ARTICLE
Vijay M Ravindra, Lucia Ruggieri, Nisha Gadgil, Angela P Addison, Ilana Patino, David D Gonda, Jason Chu, Laura Whitehead, Anne Anderson, Gloria Diaz-Medina, Kimberly Houck, Akshat Katyayan, Laura Masters, Audrey Nath, Michael Quach, James John Riviello, Elaine Seto, Krystal Elizabeth Sully, Latanya Agurs, Sonali Sen, Maureen Handoko, Rohini Coorg, Irfan Ali, Daniel Ikeda, Howard Weiner, Daniel J Curry
INTRODUCTION: In carefully selected patients with medically refractory epilepsy, disconnective hemispherotomy can result in significant seizure freedom; however, incomplete disconnection can result in ongoing seizures and poses a significant challenge. Completion hemispherotomy provides an opportunity to finish the disconnection. We describe the use of magnetic resonance-guided laser interstitial thermal ablation (MRgLITT) for completion hemispherotomy. METHODS: Patients treated with completion hemispherotomy using MRgLITT at our institution were identified...
2023: Stereotactic and Functional Neurosurgery
#40
JOURNAL ARTICLE
Mark A Damante, Nathan Rosenberg, Ammar Shaikhouni, Hannah K Johnson, Jeffrey W Leonard, Adam P Ostendorf, Jonathan A Pindrik
OBJECTIVE: To compare functional and seizure outcomes in children with vascular and dysplastic etiologies of cerebral palsy (CP) and medically intractable epilepsy (MIE) following functional hemispherotomy (FH) or anatomic hemispherectomy (AH). METHODS: Consecutive patients satisfying inclusion criteria from 07/01/2015 to 12/01/2019 were reviewed for demographic data and seizure (Engel classification) and functional (Functional Independence Measure for Children [WeeFIM]) outcomes...
April 8, 2023: World Neurosurgery
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