Abstracts

Rationale: Hemispherectomy is an established treatment for intractable childhood epilepsy. A variety of different techniques have been advocated and a range of pathologies treated with hemispherectomy. Outcomes have generally been favorable but there has been variability in technique and outcome classification. We performed a systematic review and meta-analysis of hemispherectomy outcomes in the pediatric age group.Methods: A PubMed literature search using the search terms Hemispherectomy and Outcome was performed. Filters activated were English and Child: birth-18 years . Inclusion criteria included articles centered on surgical outcome, with 10 or more exclusively pediatric patients and follow up of at least 1 year after surgery. All articles were reviewed by 2 neurosurgeons with experience in pediatric epilepsy surgery.Results: The initial PubMed search yielded 179 articles. One hundred thirty one articles failed to meet our inclusion criteria and were excluded which yielded 48 studies incorporating 1745 pediatric patients. The overall rate of seizure freedom was 69.6% (SD 15.0%). Other factors evaluated included patient demographics, characteristics of seizure history including seizure etiology, type of hemispherectomy, and surgical complications.Conclusions: This study provides further evidence that hemispherectomy is a valuable tool for treatment of intractable epilepsy in the pediatric age group.