[Functional hemispherectomy for children aged 2 years or less for the treatment of intractable epilepsy caused by cortical dysgenesis].
Thirteen children aged 2 years or less who had intractable epilepsy caused by cortical dysgenesis underwent functional hemispherectomy. The cerebral malformations were hemimegalencephaly in 8 cases and focal cortical dysplasia in 5 cases. Among 11 children who were followed for at least 6 months after the operation (6 to 54 months with a median of 26 months), 5 were seizure-free, 4 achieved > 90% seizure reduction, and 2 achieved 50-90% reduction. Ventriculo-peritoneal shunt was placed in 3 children with hemimegalencephaly. After hemispherectomy, all the children showed improvement in psychomotor development. Development was accelerated in 3 seizure-free children. In children with cortical dysgenesis, functional hemispherectomy may result in remarkable seizure reduction and steady developmental progress.
Maehara
T
T
Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Fuchu.
Shimizu
H
H
Shigetomo
R
R
Tamagawa
K
K
D000367:Age Factors; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000601:surgery*; D002675:Child, Preschool; D004827:Epilepsy / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D011597:Psychomotor Performance; D016896:Treatment Outcome