Hemispherotomy in the surgical treatment of severe symptomatic epilepsy
Purpose. To evaluate the efficacy of peri-insular functional hemispherotomy (FH) for patients with severe drug-resistant epilepsy.Materials and Methods. Nine patients underwent peri-insular functional hemispherotomy. The patients included 1 adult (11.1 %) and 8 (88.8 %) children. Patients...
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| Format: | Article |
| Language: | English |
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Romodanov Neurosurgery Institute
2019-09-01
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| Series: | Ukrainian Neurosurgical Journal |
| Online Access: | https://theunj.org/article/view/168655 |
| _version_ | 1797350285549502464 |
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| author | Kostyantyn R. Kostiuk Valeriy V. Cheburakhin Viacheslav M. Buniakin |
| author_facet | Kostyantyn R. Kostiuk Valeriy V. Cheburakhin Viacheslav M. Buniakin |
| author_sort | Kostyantyn R. Kostiuk |
| collection | DOAJ |
| description |
Purpose. To evaluate the efficacy of peri-insular functional hemispherotomy (FH) for patients with severe drug-resistant epilepsy.Materials and Methods. Nine patients underwent peri-insular functional hemispherotomy. The patients included 1 adult (11.1 %) and 8 (88.8 %) children. Patients’ age ranged from 4 to 23 years (mean 9.9 ± 4.2 years). Epilepsy duration ranged from 1.5 to 16 years (mean 7.1 ± 3.1 years), mean seizures frequency was 12.9 ± 6.8 per day; before treatment patients used on average 5.1 ± 2.6 antiepileptic drugs. Diffuse injury of one hemisphere and contralateral hemiparesis were observed in all cases. Follow-up lasted from 1 to 17 months (mean 9.6 ± 1.4 months). Three (33.3 %) patients experienced Rasmussen’s encephalitis, 2 (22.2 %) had multi-lobar cortical malformation, 2 (22.2 %) had complications associated with intracerebral hemorrhage, 1 (11.1 %) patient represented with hypoxic-ischemic encephalopathy and 1 (11.1 %) patient experienced epilepsy associated with PNET resection, chemotherapy and local radiation.Results. After FH, 7 (77.7 %) children became seizure-free (Engel Class I A), seizure recurrence was observed in one (11.1 %) case in 6 months after surgery. Perioperative complications with following death occurred in one case (11.1 %). Hydrocephalus, which required shunting developed in one (11.1 %) child.Conclusion. Functional peri-insular hemispherotomy is an effective and safe method for surgical treatment of severe symptomatic epilepsy. Seizure cessation improves psychomotor development and diminishes neurocognitive disorders. |
| first_indexed | 2024-03-08T12:42:40Z |
| format | Article |
| id | doaj.art-a9fcd08265df40d1af661db41e28a9c2 |
| institution | Directory Open Access Journal |
| issn | 2663-9084 2663-9092 |
| language | English |
| last_indexed | 2024-03-08T12:42:40Z |
| publishDate | 2019-09-01 |
| publisher | Romodanov Neurosurgery Institute |
| record_format | Article |
| series | Ukrainian Neurosurgical Journal |
| spelling | doaj.art-a9fcd08265df40d1af661db41e28a9c22024-01-21T08:27:07ZengRomodanov Neurosurgery InstituteUkrainian Neurosurgical Journal2663-90842663-90922019-09-01253354210.25305/unj.168655Hemispherotomy in the surgical treatment of severe symptomatic epilepsyKostyantyn R. Kostiuk0https://orcid.org/0000-0002-3277-5025Valeriy V. Cheburakhin1https://orcid.org/0000-0002-6820-5673Viacheslav M. Buniakin2https://orcid.org/0000-0001-8643-1693Romodanov Neurosurgery Institute, Kyiv, UkraineRomodanov Neurosurgery Institute, Kyiv, UkraineRomodanov Neurosurgery Institute, Kyiv, Ukraine Purpose. To evaluate the efficacy of peri-insular functional hemispherotomy (FH) for patients with severe drug-resistant epilepsy.Materials and Methods. Nine patients underwent peri-insular functional hemispherotomy. The patients included 1 adult (11.1 %) and 8 (88.8 %) children. Patients’ age ranged from 4 to 23 years (mean 9.9 ± 4.2 years). Epilepsy duration ranged from 1.5 to 16 years (mean 7.1 ± 3.1 years), mean seizures frequency was 12.9 ± 6.8 per day; before treatment patients used on average 5.1 ± 2.6 antiepileptic drugs. Diffuse injury of one hemisphere and contralateral hemiparesis were observed in all cases. Follow-up lasted from 1 to 17 months (mean 9.6 ± 1.4 months). Three (33.3 %) patients experienced Rasmussen’s encephalitis, 2 (22.2 %) had multi-lobar cortical malformation, 2 (22.2 %) had complications associated with intracerebral hemorrhage, 1 (11.1 %) patient represented with hypoxic-ischemic encephalopathy and 1 (11.1 %) patient experienced epilepsy associated with PNET resection, chemotherapy and local radiation.Results. After FH, 7 (77.7 %) children became seizure-free (Engel Class I A), seizure recurrence was observed in one (11.1 %) case in 6 months after surgery. Perioperative complications with following death occurred in one case (11.1 %). Hydrocephalus, which required shunting developed in one (11.1 %) child.Conclusion. Functional peri-insular hemispherotomy is an effective and safe method for surgical treatment of severe symptomatic epilepsy. Seizure cessation improves psychomotor development and diminishes neurocognitive disorders.https://theunj.org/article/view/168655 |
| spellingShingle | Kostyantyn R. Kostiuk Valeriy V. Cheburakhin Viacheslav M. Buniakin Hemispherotomy in the surgical treatment of severe symptomatic epilepsy Ukrainian Neurosurgical Journal |
| title | Hemispherotomy in the surgical treatment of severe symptomatic epilepsy |
| title_full | Hemispherotomy in the surgical treatment of severe symptomatic epilepsy |
| title_fullStr | Hemispherotomy in the surgical treatment of severe symptomatic epilepsy |
| title_full_unstemmed | Hemispherotomy in the surgical treatment of severe symptomatic epilepsy |
| title_short | Hemispherotomy in the surgical treatment of severe symptomatic epilepsy |
| title_sort | hemispherotomy in the surgical treatment of severe symptomatic epilepsy |
| url | https://theunj.org/article/view/168655 |
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