Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section
Introduction: The surgical procedure for severe, drug-resistant, unilateral hemispheric epilepsy is challenging. Over the last decades the surgical landscape for hemispheric disconnection procedures changed from anatomical hemispherectomy to functional hemispherotomy with a reduction of complication...
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2024-01-01
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| author | Olaf E.M.G. Schijns Daniel Delev Marec von Lehe Dirk van Roost Karl Rössler Tom Theys Christian Auer Thomas Blauwblomme Marcelo Budke Alexandre Rainha Campos Santiago Candela Canto Hans Clusmann Christian Dorfer Georg Dorfmüller Arild Egge Lorand Eröss Sarah Ferrand-Sorbets Flavio Giordano Jürgen Honegger Cihan Isler Jugoslav Ivanovic Thilo Kalbhenn Atte Karppinen Niklaus Krayenbühl Rick H.G.J. van Lanen Carlo E. Marras Ioannis Mavridis Daniel Nilsson Julia Onken Christian Raftopoulos Jonathan Roth Jordi Rumia Thomas Sauvigny Didier Scavarda Karl Schaller Christian Scheiwe Sophie Schuind Alexandra Seromenho-Santos Kostas Fountas |
| author_facet | Olaf E.M.G. Schijns Daniel Delev Marec von Lehe Dirk van Roost Karl Rössler Tom Theys Christian Auer Thomas Blauwblomme Marcelo Budke Alexandre Rainha Campos Santiago Candela Canto Hans Clusmann Christian Dorfer Georg Dorfmüller Arild Egge Lorand Eröss Sarah Ferrand-Sorbets Flavio Giordano Jürgen Honegger Cihan Isler Jugoslav Ivanovic Thilo Kalbhenn Atte Karppinen Niklaus Krayenbühl Rick H.G.J. van Lanen Carlo E. Marras Ioannis Mavridis Daniel Nilsson Julia Onken Christian Raftopoulos Jonathan Roth Jordi Rumia Thomas Sauvigny Didier Scavarda Karl Schaller Christian Scheiwe Sophie Schuind Alexandra Seromenho-Santos Kostas Fountas |
| author_sort | Olaf E.M.G. Schijns |
| collection | DOAJ |
| description | Introduction: The surgical procedure for severe, drug-resistant, unilateral hemispheric epilepsy is challenging. Over the last decades the surgical landscape for hemispheric disconnection procedures changed from anatomical hemispherectomy to functional hemispherotomy with a reduction of complications and stable good seizure outcome. Here, a task force of European epilepsy surgeons prepared, on behalf of the EANS Section for Functional Neurosurgery, a consensus statement on different aspects of the hemispheric disconnection procedure. Research question: To determine history, indication, timing, techniques, complications and current practice in Europe for hemispheric disconnection procedures in drug-resistant epilepsy. Material and methods: Relevant literature on the topic was collected by a literature search based on the PRISMA 2020 guidelines. Results: A comprehensive overview on the historical development of hemispheric disconnection procedures for epilepsy is presented, while discussing indications, timing, surgical techniques and complications. Current practice for this procedure in European epilepsy surgery centers is provided. At present, our knowledge of long-term seizure outcomes primarily stems from open surgical disconnection procedures. Although minimal invasive surgical techniques in epilepsy are rapidly developing and reported in case reports or small case series, long-term seizure outcome remain uncertain and needs to be reported. Discussion and conclusion: This is the first paper presenting a European consensus statement regarding history, indications, techniques and complications of hemispheric disconnection procedures for different causes of chronic, drug-resistant epilepsy. Furthermore, it serves as the pioneering document to report a comprehensive overview of the current surgical practices regarding this type of surgery employed in renowned epilepsy surgery centers across Europe. |
| format | Article |
| id | doaj-art-1962852b98e543c8bd6ab8e866e94dae |
| institution | OA Journals |
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| language | English |
| publishDate | 2024-01-01 |
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| series | Brain and Spine |
| spelling | doaj-art-1962852b98e543c8bd6ab8e866e94dae2025-08-20T02:35:40ZengElsevierBrain and Spine2772-52942024-01-01410275410.1016/j.bas.2024.102754Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery sectionOlaf E.M.G. Schijns0Daniel Delev1Marec von Lehe2Dirk van Roost3Karl Rössler4Tom Theys5Christian Auer6Thomas Blauwblomme7Marcelo Budke8Alexandre Rainha Campos9Santiago Candela Canto10Hans Clusmann11Christian Dorfer12Georg Dorfmüller13Arild Egge14Lorand Eröss15Sarah Ferrand-Sorbets16Flavio Giordano17Jürgen Honegger18Cihan Isler19Jugoslav Ivanovic20Thilo Kalbhenn21Atte Karppinen22Niklaus Krayenbühl23Rick H.G.J. van Lanen24Carlo E. Marras25Ioannis Mavridis26Daniel Nilsson27Julia Onken28Christian Raftopoulos29Jonathan Roth30Jordi Rumia31Thomas Sauvigny32Didier Scavarda33Karl Schaller34Christian Scheiwe35Sophie Schuind36Alexandra Seromenho-Santos37Kostas Fountas38Corresponding author. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands.; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands; Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht-Heeze, the Netherlands; School for Mental Health and Neuroscience (MHeNs), University Maastricht (UM), Maastricht, the NetherlandsDepartment of Neurosurgery, RWTH Aachen University Hospital, Aachen, GermanyDepartment of Neurosurgery, Ruppiner Kliniken, Neuruppin, GermanyDepartment of Neurosurgery, University Hospital Ghent, Ghent, BelgiumDepartment of Neurosurgery, Medical University of Vienna, Vienna, AustriaDepartment of Neurosurgery, University Hospital Leuven, Leuven, BelgiumDepartment of Neurosurgery, Johannes Kepler University Linz, Kepler University Hospital, Linz, AustriaDepartment of Pediatric Neurosurgery, Hôpital Necker, Université de Paris, Paris, FranceDepartment of Neurosurgery, Hospital Infantil Universitario Niño Jesús, Madrid, SpainDepartment of Neurosurgery, Hospital Santa Maria, Lisbon, PortugalDepartment of Neurosurgery, Hospital Sant Joan de Deu, Barcelona, SpainDepartment of Neurosurgery, RWTH Aachen University Hospital, Aachen, GermanyDepartment of Neurosurgery, Medical University of Vienna, Vienna, AustriaDepartment of Neurosurgery, Hopital Fondation Adolphe de Rothschild, Paris, FranceDepartment of Neurosurgery, Oslo University Hospital, Oslo, NorwayDepartment of Neurosurgery, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, HungaryDepartment of Neurosurgery, Hopital Fondation Adolphe de Rothschild, Paris, FranceDepartment of Neurosurgery, Meyer Children's Hospital IRCCS, University of Florence, ItalyDepartment of Neurosurgery, University Hospital, Tübingen, GermanyDepartment of Neurosurgery, Istanbul University-Cerrahpasa, Istanbul, TurkeyDepartment of Neurosurgery, Oslo University Hospital, Oslo, NorwayDepartment of Neurosurgery, Bielefeld University, Medical School, Bielefeld, GermanyDepartment of Neurosurgery, University of Helsinki, Helsinki University hospital, Helsinki, FinlandDepartment of Neurosurgery, Universitäts-Kinderspital Zürich-Eleonorenstiftung, Zürich, SwitzerlandDepartment of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), University Maastricht (UM), Maastricht, the NetherlandsDepartment of Neurosurgery, Ospedale Pediatrico Bambino Gesu, Roma, ItalyDepartment of Neurosurgery, University General Hospital of Alexandroupolis, Alexandroupolis, GreeceDepartment of Neurosurgery, Sahlgrenska University hospital, Göteborg, SwedenDepartment of Neurosurgery, Charite University hospital, Berlin, GermanyDepartment of Neurosurgery, Clinique Universitaires Saint Luc, Brussels, BelgiumDepartment of Neurosurgery, Tel Aviv Sourasky medical center, Tel Aviv, IsraelDepartment of Neurosurgery, Hospital Sant Joan de Deu, Barcelona, SpainDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurosurgery, Hopital La Timone Enfants, Marseille, FranceDepartment of Neurosurgery, Geneva University Medical Center, Geneva, SwitzerlandDepartment of Neurosurgery, University hospital, Freiburg, GermanyDepartment of Neurosurgery, Hopital Erasme, Brussels, BelgiumDepartment of Neurosurgery, Centro Hospitalar de Lisboa Ocidental, Lisbon, PortugalDepartment of Neurosurgery, University of Thessaly Medical School, Larissa, GreeceIntroduction: The surgical procedure for severe, drug-resistant, unilateral hemispheric epilepsy is challenging. Over the last decades the surgical landscape for hemispheric disconnection procedures changed from anatomical hemispherectomy to functional hemispherotomy with a reduction of complications and stable good seizure outcome. Here, a task force of European epilepsy surgeons prepared, on behalf of the EANS Section for Functional Neurosurgery, a consensus statement on different aspects of the hemispheric disconnection procedure. Research question: To determine history, indication, timing, techniques, complications and current practice in Europe for hemispheric disconnection procedures in drug-resistant epilepsy. Material and methods: Relevant literature on the topic was collected by a literature search based on the PRISMA 2020 guidelines. Results: A comprehensive overview on the historical development of hemispheric disconnection procedures for epilepsy is presented, while discussing indications, timing, surgical techniques and complications. Current practice for this procedure in European epilepsy surgery centers is provided. At present, our knowledge of long-term seizure outcomes primarily stems from open surgical disconnection procedures. Although minimal invasive surgical techniques in epilepsy are rapidly developing and reported in case reports or small case series, long-term seizure outcome remain uncertain and needs to be reported. Discussion and conclusion: This is the first paper presenting a European consensus statement regarding history, indications, techniques and complications of hemispheric disconnection procedures for different causes of chronic, drug-resistant epilepsy. Furthermore, it serves as the pioneering document to report a comprehensive overview of the current surgical practices regarding this type of surgery employed in renowned epilepsy surgery centers across Europe.http://www.sciencedirect.com/science/article/pii/S2772529424000109Epilepsy surgeryFunctional hemispherotomyHemispheric disconnectionIndicationsTechniquesComplications |
| spellingShingle | Olaf E.M.G. Schijns Daniel Delev Marec von Lehe Dirk van Roost Karl Rössler Tom Theys Christian Auer Thomas Blauwblomme Marcelo Budke Alexandre Rainha Campos Santiago Candela Canto Hans Clusmann Christian Dorfer Georg Dorfmüller Arild Egge Lorand Eröss Sarah Ferrand-Sorbets Flavio Giordano Jürgen Honegger Cihan Isler Jugoslav Ivanovic Thilo Kalbhenn Atte Karppinen Niklaus Krayenbühl Rick H.G.J. van Lanen Carlo E. Marras Ioannis Mavridis Daniel Nilsson Julia Onken Christian Raftopoulos Jonathan Roth Jordi Rumia Thomas Sauvigny Didier Scavarda Karl Schaller Christian Scheiwe Sophie Schuind Alexandra Seromenho-Santos Kostas Fountas Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section Brain and Spine Epilepsy surgery Functional hemispherotomy Hemispheric disconnection Indications Techniques Complications |
| title | Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section |
| title_full | Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section |
| title_fullStr | Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section |
| title_full_unstemmed | Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section |
| title_short | Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section |
| title_sort | functional hemispheric disconnection procedures for chronic epilepsy history indications techniques complications and current practice in europe a consensus statement on behalf of the eans functional neurosurgery section |
| topic | Epilepsy surgery Functional hemispherotomy Hemispheric disconnection Indications Techniques Complications |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424000109 |
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