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Childs Nerv Syst. 2006 Aug;22(8):967-81. Epub 2006 Jun 29.

Peri-insular hemispherotomy in paediatric epilepsy.

Author information

1
Neurosurgery Service, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011, Lausanne, Switzerland. jean-guy.villemure@chuv.ch

Abstract

OBJECTS:

Outline the indications, investigation, surgical technique, pitfalls, complications and benefits of peri-insular hemispherotomy (PIH) in the surgical treatment of paediatric epilepsy.

MATERIALS AND METHODS:

This report is based on a consecutive series of 43 children who underwent PIH. Sixty percent were males; there were slightly more left-sided surgeries. Median interval between seizure onset and surgery was 5 years. In more than half the cases, the anatomical substrate was congenital. There were few complications: one death, one hydrocephalus and two anatomically remote haemorrhages. Ninety percent of the patients have remained in Engel's class I epilepsy outcome.

CONCLUSIONS:

There are clear indications for hemispherectomy in children. In some instances of incomplete deficit, timing of surgery remains a major concern. The less invasive approach to eliminate the influence of the diseased hemisphere, in our opinion, is with disconnective techniques of hemispherectomy, and among the latter, peri-insular hemispherotomy provides, in our opinion, the best complications-benefits ratio.

PMID:
16804712
DOI:
10.1007/s00381-006-0134-3
[Indexed for MEDLINE]

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