Cerebral hemispherectomy in pediatric patients with epilepsy: comparison of three techniques by pathological substrate in 115 patients

Cook, Shon W; Nguyen, Snow; Hu, Bin; Yudovin, Sue; Shields, W. Donald; Vinters, Harry V.; Wiele, Barbara M. Van de; Harrison, Rick; Mathern, Gary W.

doi:10.3171/ped.2004.100.2.0125

Cited by 132 publications

(183 citation statements)

References 34 publications

Supporting

Mentioning

158

Contrasting

Unclassified

Order By: Relevance

“…Anatomical hemispherectomy was associated with a significantly higher shunt rate than functional hemispherectomy (p < 0.05) and hemispherotomy (p < 0.01). One of the 4 studies in the anatomical hemispherectomy group had a shunt rate of 78%, 6 which was considerably higher than the shunt rate in the other 3 studies. The study, however, was included because it contributed 37 patients and was the single largest contributor to this group (54.4%) ( Table 5; Fig.…”

Section: Hydrocephalus Complications and Mortalitymentioning

confidence: 88%

See 1 more Smart Citation

Hemispherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review

Griessenauer

Salam

Hendrix

et al. 2015

PED

137

112

View full text Add to dashboard Cite

OBJECT Evidence in support of hemispherectomy stems from a multitude of retrospective studies illustrating individual institutions' experience. A systematic review of this topic, however, is lacking in the literature. METHODS A systematic review of hemispherectomy for the treatment of refractory epilepsy available up to October 2013 was performed using the following inclusion criteria: reports of a total of 10 or more patients in the pediatric age group (≤ 20 years) undergoing hemispherectomy, seizure outcome reported after a minimum follow-up of 1 year after the initial procedure, and description of the type of hemispherectomy. Only the most recent paper from institutions that published multiple papers with overlapping study periods was included. Two reviewers independently applied the inclusion criteria and extracted all the data. RESULTS Twenty-nine studies with a total of 1161 patients met the inclusion criteria. Seizure outcome was available for 1102 patients, and the overall rate of seizure freedom at the last follow-up was 73.4%. Sixteen studies (55.2%) exclusively reported seizure outcomes of a single type of hemispherectomy. There was no statistically significant difference in seizure outcome and type of hemispherectomy (p = 0.737). Underlying etiology was reported for 85.4% of patients with documented seizure outcome, and the overall distribution of acquired, developmental, and progressive etiologies was 30.5%, 40.7%, and 28.8%, respectively. Acquired and progressive etiologies were associated with significantly higher seizure-free rates than developmental etiologies (p < 0.001). Twenty of the 29 studies (69%) reported complications. The overall rate of hydrocephalus requiring CSF diversion was 14%. Mortality within 30 days was 2.2% and was not statistically different between types of hemispherectomy (p = 0.787). CONCLUSIONS Hemispherectomy is highly effective for treating refractory epilepsy in the pediatric age group, particularly for acquired and progressive etiologies. While the type of hemispherectomy does not have any influence on seizure outcome, hemispherotomy procedures are associated with a more favorable complication profile.

show abstract

Section: Hydrocephalus Complications and Mortalitymentioning

confidence: 88%

“…1) into anatomical hemispherectomy, functional hemispherectomy (Fig. 1B), 6,28 hemispherotomy including trans-and perisylvian (Fig. 1C) 30,31,33,44 and vertical parasagittal techniques (Fig.…”

Section: Methodsmentioning

confidence: 99%

Hemispherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review

Griessenauer

Salam

Hendrix

et al. 2015

PED

137

112

View full text Add to dashboard Cite

show abstract

“…The kinds of seizures varied greatly, with daily occurrences of up to 250 episodes [32]. The cerebral hemispherectomy procedure was anatomical in participants 2F and 7M and functional, with complete disconnection, in the rest of the group [33]. The procedure arrested seizure activity in 6/7 participants, and, within 1-3 years, antiepileptic drugs were discontinued in all but 2 participants.…”

Section: Recruitment and Clinical Variablesmentioning

confidence: 99%

“…

…”

mentioning

confidence: 99%

Literacy after cerebral hemispherectomy: Can the isolated right hemisphere read?

Bode¹,

Chanturidze

Mathern

et al. 2015

Epilepsy & Behavior

Self Cite

View full text Add to dashboard Cite

Objectives: Cerebral hemispherectomy, a surgical procedure undergone to control intractable seizures, is becoming a standard procedure with more cases identified and treated early in life [33]. While the effect of the dominant hemisphere resection on spoken language has been extensively researched, little is known about reading abilities in individuals after left-sided resection. Left-lateralized phonological abilities are the key components of reading, i.e., grapheme-phoneme conversion skills [1]. These skills are critical for the acquisition of wordspecific orthographic knowledge and have been shown to predict reading levels in average readers as well as in readers with mild cognitive disability [26]. Furthermore, impaired phonological processing has been implicated as the cognitive basis in struggling readers. Here, we explored the reading skills in participants who have undergone left cerebral hemispherectomy. Methods: Seven individuals who have undergone left cerebral hemispherectomy to control intractable seizures associated with perinatal infarct have been recruited for this study. We examined if components of phonological processing that are shown to reliably separate average readers from struggling readers, i.e., phonological awareness, verbal memory, speed of retrieval, and size of vocabulary, show the same relationship to reading levels when they are mediated by the right hemisphere [2]. Results: We found that about 60% of our group developed both word reading and paragraph reading in the average range. Phonological processing measured by both phonological awareness and nonword reading was unexpectedly spared in the majority of participants. Phonological awareness levels strongly correlated with word reading. Verbal memory, a component of phonological processing skills, together with receptive vocabulary size, positively correlated with reading levels similar to those reported in average readers. Receptive vocabulary, a bilateral function, was preserved to a certain degree similar to that of strongly left-lateralized phonological skills [3]. Later seizure onset was associated with better reading levels. Conclusions: When cerebral hemispherectomy is performed to control seizures associated with very early (in utero) insult, it has been found that the remaining right hemisphere is still able to support reading and phonological processing skills that are normally mediated by the left hemisphere. Our results also suggest the existence of variability in individuals after hemispherectomy, even within groups having the same etiology and similar timing of insult.Published by Elsevier Inc.

show abstract

“…9,10,18,21,22,34,36,55,60,65 When comparing different techniques, the seizure outcome seems to be constant. Another case series comparing anatomical hemispherectomy, functional hemispherectomy, and hemispherotomy 12 showed no significant differences between the 3 groups, with 71% of patients overall…”

Section: Surgical Outcomementioning

confidence: 99%

Hemispherotomy and other disconnective techniques

Ribaupierre

Delalande

2008

FOC

View full text Add to dashboard Cite

The surgical treatment of intractable epilepsy has evolved as new technical innovations have been made. Hemispherotomy techniques have been developed to replace hemispherectomy in order to reduce the complication rates while maintaining good seizure control. Disconnective procedures are based on the interruption of the epileptic network rather than the removal of the epileptogenic zone. They can be applied to hemispheric pathologies, leading to hemispherotomy, but they can also be applied to posterior quadrant epilepsies, or hypothalamic hamartomas. In this paper, the authors review the literature, present an overview of the historical background, and discuss the different techniques along with their outcomes and complications.

show abstract

Cerebral hemispherectomy in pediatric patients with epilepsy: comparison of three techniques by pathological substrate in 115 patients

Cited by 132 publications

References 34 publications

Hemispherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review

Hemispherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review

Literacy after cerebral hemispherectomy: Can the isolated right hemisphere read?

Hemispherotomy and other disconnective techniques

Contact Info

Product

Resources

About