Early surgery for infantile intractable epilepsy associated with hemimegalencephaly.
Abstract number :
2.295
Submission category :
9. Surgery
Year :
2010
Submission ID :
12889
Source :
www.aesnet.org
Presentation date :
12/3/2010 12:00:00 AM
Published date :
Dec 2, 2010, 06:00 AM
Authors :
Akio Takahashi, T. Otsuki, T. Kaido, Y. Kaneko, E. Nakagawa, K. Sugai and M. Sasaki
Rationale: Hemimegalencephaly (HME) is a severe malformative condition and usually patients exhibit catastrophic epilepsy that develops soon after birth. We describe seizure control and developmental outcome following vertical parasagittal hemispherotomy(VPH) for infantile intractable epilepsy with HME. Methods: Retrospective analysis of 12 patients (ages 2 -9 months) who underwent VPH from 2003 to 2009 with a minimum follow-up period of 1 year. Results: 11 patients (92%) exhibited preoperatively early epileptic encephalopathy with suppression-bursts. Mean preoperative developmental quotient (DQ) was 33.5. Mean age at surgery was 4.5 months. After VPH, 8 patients (67%) were Engel Class I and 4 continued to have seizures and were classified as Engel Class II(1 case) III (1 case) or IV (2 cases) . Patients with favorable seizure outcome( Class I II) showed an increase in DQ. Conclusions: Early VPH should be considered for infantile intractable epilepsy with HME, despite severe diffuse electroencephalogram abnormalities.
Surgery