caa a22 4500 463180054 CHVBK 20180406164836.0 cr unu---uuuuu 170326e20070301xx s 000 0 eng 10.1007/s00381-006-0212-6 doi (NATIONALLICENCE)springer-10.1007/s00381-006-0212-6 Outcome of hemispheric surgeries for refractory epilepsy in pediatric patients [Elektronische Daten] [Vera Terra-Bustamante, Luciana Inuzuka, Regina Fernandes, Sara Escorsi-Rosset, Lauro Wichert-Ana, Veriano Alexandre Jr., Marino Bianchin, David Araújo, Antônio Santos, Ricardo Oliveira dos Santos, Helio Machado, Américo Sakamoto] Background: Hemispheric brain lesions are commonly associated with early onset of catastrophic epilepsies and multiple seizure types. Hemispheric surgery is indicated for patients with unilateral intractable epilepsy. Although described more than 50years ago, several new techniques for hemispherectomy have only recently been proposed aiming to reduce operatory risks and morbidity. Materials and methods: We present the clinical characteristics, presurgical workup, and postoperative outcome of a series of pediatric patients who underwent hemispherectomy for medically intractable epileptic seizures. Thirty-nine patients with medically intractable epilepsy underwent surgery from 1996 to 2005. Results and discussion: We analyzed demographic data, interictal and ictal EEG findings, age at surgery, surgical technique and complications, and postsurgical seizure outcome. There were 74.4% males. Tonic and focal motor seizures occurred in 30.8 and 20.5% of the patients. Most frequent etiologies were Rasmussen encephalitis (30.8%) and malformation of cortical development (23.1%). Postsurgical outcomes were Engel classes I and II for 61.5% of the patients. In general, 89.5% of the patients exhibited at least a 90% reduction in seizure frequency. All patients had acute worsening of hemiparesis after surgery. Basically, two surgical techniques have been employed, both with similar results, although a trend has been noted toward one of the procedures which produced consistently complete disconnection. Patients with hemispheric brain lesions usually have abnormal neurological development and intractable epilepsy. When video-EEG monitoring and magnetic resonance imaging show unilateral disease, the patient may evolve with a good surgical outcome. We showed that a marked reduction in seizure frequency may be achieved, with acceptable neurological impairments. Springer-Verlag, 2006 Hemispherotomy nationallicence Epilepsy surgery in children nationallicence Outcome of hemispheric surgery nationallicence Terra-Bustamante Vera Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Inuzuka Luciana Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Fernandes Regina Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Escorsi-Rosset Sara Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Wichert-Ana Lauro Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Alexandre Jr. Veriano Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Bianchin Marino Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Araújo David Department of Radiology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Santos Antônio Department of Radiology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Oliveira dos Santos Ricardo Department of Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Machado Helio Department of Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Sakamoto Américo Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut Child's Nervous System Springer-Verlag 23/3(2007-03-01), 321-326 0256-7040 23:3<321 2007 23 381 https://doi.org/10.1007/s00381-006-0212-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-006-0212-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Terra-Bustamante Vera Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Inuzuka Luciana Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Fernandes Regina Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Escorsi-Rosset Sara Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Wichert-Ana Lauro Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Alexandre Jr Veriano Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Bianchin Marino Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Araújo David Department of Radiology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Santos Antônio Department of Radiology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Oliveira dos Santos Ricardo Department of Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Machado Helio Department of Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 700 1- Sakamoto Américo Department of Neurology, Psychiatry and Psychology,Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/3(2007-03-01), 321-326 0256-7040 23:3<321 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer