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Hemispherotomy for children with intractable epilepsy

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Author:
No author available
Journal Title:
Chinese Journal of Neurosurgery
Issue:
10
DOI:
10.3760/cma.j.issn.1001-2346.2012.10.009
Key Word:
癫痫;半球离断术;儿童;Epilepsy;Hemispherotomy;Child

Abstract: Objective To assess the surgical techniques and surgical outcomes of hemispherotomy for children with intractable epilepsy.Methods The authors conducted a retrospective review of clinical,neuropsychological,electroencephalogram ( EEG),imaging data in 12 children with intractable epilepsy who underwent hemispherotomy between August 2007 and October 2011.Of the 12 cases,7 were males and 5 were females.The age of seizure onset was from 0.1 to 10 years ( average 4.2) and disease duration of 0.7 to 7 years ( average 3.3).The surgery was performed between the age of 2.1 and 11.9 years ( average 7.6).One patient underwent trans - sylvian hemispherotomy,4 patients underwent hemispherotomy through an interhemispheric approach and temporal resection,5 hemispherotomy through a central cortex approach and temporal resection,2 peri - insular hemispherotomy and temporal lobe and pars perculairs resection.Results After a mean follow -up of 2.18 years months (range 0.5 -4.5 years),10 patients had seizure free,one patient had Engel Class Ⅱ seizure outcome and one patient had Engel class Ⅲ outcome.1 patient underwent a second surgical procedure due to incomplete disconnections.All of the patients had increases in cognitive abilities and quality of life after the surgery.After the surgery,all of the patients can walk independently,but the fine movements of the hands were lost.Up to now,hydrocephalus and superficial cerebral hemosiderosis were not discovered and no death case in this study.Conclusion Hemispherotomy is a safety and effective epilepsy surgery procedure for children with intractable epilepsy.

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