[Functional hemispherectomy: long-term follow-up in a series of five patients].

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[Functional hemispherectomy: long-term follow-up in a series of five patients].

Rev Neurol. 2018 Mar 01;66(5):147-153

Authors: Rodriguez-Osorio X, Lopez-Gonzalez FJ, Eiris-Punal J, Frieiro-Dantas C, Gomez-Lado C, Peleteiro-Fernandez M, Prieto-Gonzalez A

Abstract
INTRODUCTION: Functional hemispherectomy consists in palliative epilepsy surgical procedure usually performed in patients with pharmaco-resistant epilepsy and hemispheric syndromes. It is based on the neural disconnection of the affected hemisphere with preservation of the vascular supply.
AIM: To analyze long-term prognosis and safety of the hemispherectomies performed in our institution.
PATIENTS AND METHODS: Retrospective analysis collecting the following variables: age, gender, age of epilepsy onset, type of seizures, etiology, age of epilepsy surgery, prognosis and potential surgical complications. All patients had a minimum of five years of follow up.
RESULTS: Five patients (60% females) underwent hemispherotomy between 1999 and 2010. Age of epilepsy onset was 36 months and time of evolution until surgery was 7 years. The most frequent type of seizures were simple motor seizures with secondary generalization (n = 5). Three patients remained seizure free persistently after surgery and another patient had a more than 90% improvement. Time of follow up was 13 years. One patient suffered a bacterial meningitis without sequelae. Six years after surgery a patient suffered hydrocephalous requiring ventriculoperitoneal shunt.
CONCLUSIONS: Functional hemispherectomy constitutes an effective method to treat patients with pharmaco-resistant epilepsy, extensive unihemispheric pathology and seizures limited to that hemisphere. Late complications may occur thus long-term follow-up is needed.

PMID: 29480510 [PubMed - indexed for MEDLINE]

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