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Child's Nervous System

, Volume 12, Issue 7, pp 376–384 | Cite as

Hemispherectomy for intractable seizures in children: a report of 58 cases

  • Warwick J. Peacock
  • Monica C. Wehby-Grant
  • W. Donald Shields
  • D. Alan Shewmon
  • Harry T. Chugani
  • Raman Sankar
  • Harry V. Vinters
Original Paper
Received:

Abstract

Fifty-eight children who underwent anatomical, functional, or modified anatomical hemispherectomy for intractable seizures from 1986 to 1995 were evaluated for seizure control, motor function, and complications. Age at surgery ranged from 0.3 to 17.3 years (median 2.8 years). Twenty-seven anatomical, 27 functional, and 4 modified anatomical hemispherectomies were performed. Seizure control and motor function in the 50 patients with more than 1 year follow-up revealed a 90% or better reduction in seizure frequency in 44/50 (88%) overall: 19/22 (86%) anatomical, 23/26 (89%) functional, and 2/2 modified anatomical. Motor function of the preoperatively hemiparetic extremities was improved or unchanged postoperatively in 38/50 (76%) of the patients. Complications included one intraoperative death, one late death from shunt obstruction managed elsewhere, late postoperative seizure breakthrough requiring reoperation and further disconnection in 5/27 functional hemispherectomy patients, mild cerebrospinal fluid infections in 3/27 anatomical hemispherectomy patients, and hydrocephalus requiring shunting in 3/27 functional hemispherectomy patients. A review of the literature and comparison of techniques is presented.

Key words

Hemispherectomy Epilepsy Infantile hemiplegia Surgery Children 
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Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Warwick J. Peacock
    • 1
  • Monica C. Wehby-Grant
    • 1
  • W. Donald Shields
    • 2
  • D. Alan Shewmon
    • 2
  • Harry T. Chugani
    • 3
  • Raman Sankar
    • 2
  • Harry V. Vinters
    • 4
    • 5
  1. 1.Division of Neurosurgery, Department of SurgeryUCLA Medical CenterLos AngelesUSA
  2. 2.Department of Pediatric NeurologyUCLA Medical CenterLos AngelesUSA
  3. 3.Department of PediatricsChildren's Hospital of Michigan at DetroitDetroitUSA
  4. 4.Department of Pathology and Laboratory Medicine (Neuropathology)UCLA Medical CenterLos AngelesUSA
  5. 5.the Brain Research InstituteUCLA Medical CenterLos AngelesUSA

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