Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy
Objectives: To study the outcome of disconnective epilepsy surgery for intractable hemispheric and sub-hemispheric pediatric epilepsy. Methods: A retrospective analysis of the epilepsy surgery database was done in all children (age <18 years) who underwent a peri-insular hemispherotomy (PIH) or a...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | International Journal of Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2012/527891 |
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| author | Santhosh George Thomas Ari George Chacko Maya Mary Thomas K. Srinivasa Babu Paul Swamidhas Sudhakar Russell Roy Thomas Daniel |
| author_facet | Santhosh George Thomas Ari George Chacko Maya Mary Thomas K. Srinivasa Babu Paul Swamidhas Sudhakar Russell Roy Thomas Daniel |
| author_sort | Santhosh George Thomas |
| collection | DOAJ |
| description | Objectives: To study the outcome of disconnective epilepsy surgery for intractable hemispheric and sub-hemispheric pediatric epilepsy. Methods: A retrospective analysis of the epilepsy surgery database was done in all children (age <18 years) who underwent a peri-insular hemispherotomy (PIH) or a peri-insular posterior quadrantectomy (PIPQ) from April 2000 to March 2011. All patients underwent a detailed pre surgical evaluation. Seizure outcome was assessed by the Engel’s classification and cognitive skills by appropriate measures of intelligence that were repeated annually. Results: There were 34 patients in all. Epilepsy was due to Rasmussen’s encephalitis (RE), Infantile hemiplegia seizure syndrome (IHSS), Hemimegalencephaly (HM), Sturge Weber syndrome (SWS) and due to post encephalitic sequelae (PES). Twenty seven (79.4%) patients underwent PIH and seven (20.6%) underwent PIPQ. The mean follow up was 30.5 months. At the last follow up, 31 (91.1%) were seizure free. The age of seizure onset and etiology of the disease causing epilepsy were predictors of a Class I seizure outcome. Conclusions: There is an excellent seizure outcome following disconnective epilepsy surgery for intractable hemispheric and subhemispheric pediatric epilepsy. An older age of seizure onset, RE, SWS and PES were good predictors of a Class I seizure outcome. |
| format | Article |
| id | doaj-art-601e9b825da542699aa4e9d1580db09c |
| institution | Kabale University |
| issn | 1687-9740 1687-9759 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Pediatrics |
| spelling | doaj-art-601e9b825da542699aa4e9d1580db09c2025-08-20T03:34:48ZengWileyInternational Journal of Pediatrics1687-97401687-97592012-01-01201210.1155/2012/527891527891Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric EpilepsySanthosh George Thomas0Ari George Chacko1Maya Mary Thomas2K. Srinivasa Babu3Paul Swamidhas Sudhakar Russell4Roy Thomas Daniel5Division of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore 632004, IndiaDivision of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore 632004, IndiaDivision of Pediatric Neurology, Department of Neurological Sciences, Christian Medical College, Vellore 632004, IndiaDivision of Neurophysiology, Department of Neurological Sciences, Christian Medical College, Vellore 632004, IndiaDepartment of Child and Adolescent Psychiatry, Christian Medical College, Vellore 632004, IndiaDivision of Neurosurgery, Department of Clinical Neurosciences, CHUV, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandObjectives: To study the outcome of disconnective epilepsy surgery for intractable hemispheric and sub-hemispheric pediatric epilepsy. Methods: A retrospective analysis of the epilepsy surgery database was done in all children (age <18 years) who underwent a peri-insular hemispherotomy (PIH) or a peri-insular posterior quadrantectomy (PIPQ) from April 2000 to March 2011. All patients underwent a detailed pre surgical evaluation. Seizure outcome was assessed by the Engel’s classification and cognitive skills by appropriate measures of intelligence that were repeated annually. Results: There were 34 patients in all. Epilepsy was due to Rasmussen’s encephalitis (RE), Infantile hemiplegia seizure syndrome (IHSS), Hemimegalencephaly (HM), Sturge Weber syndrome (SWS) and due to post encephalitic sequelae (PES). Twenty seven (79.4%) patients underwent PIH and seven (20.6%) underwent PIPQ. The mean follow up was 30.5 months. At the last follow up, 31 (91.1%) were seizure free. The age of seizure onset and etiology of the disease causing epilepsy were predictors of a Class I seizure outcome. Conclusions: There is an excellent seizure outcome following disconnective epilepsy surgery for intractable hemispheric and subhemispheric pediatric epilepsy. An older age of seizure onset, RE, SWS and PES were good predictors of a Class I seizure outcome.http://dx.doi.org/10.1155/2012/527891 |
| spellingShingle | Santhosh George Thomas Ari George Chacko Maya Mary Thomas K. Srinivasa Babu Paul Swamidhas Sudhakar Russell Roy Thomas Daniel Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy International Journal of Pediatrics |
| title | Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy |
| title_full | Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy |
| title_fullStr | Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy |
| title_full_unstemmed | Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy |
| title_short | Outcomes of Disconnective Surgery in Intractable Pediatric Hemispheric and Subhemispheric Epilepsy |
| title_sort | outcomes of disconnective surgery in intractable pediatric hemispheric and subhemispheric epilepsy |
| url | http://dx.doi.org/10.1155/2012/527891 |
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