Effectiveness of cerebral hemispherotomy for improving behavioral disorders associated with intractable post-traumatic seizures.
A 25-year-old man presented with intractable post-traumatic seizures after suffering cerebral contusion in a traffic accident at age 5 years. Cerebral hemispherotomy was performed to transect the neuronal fibers to interrupt connections between seizure foci in wide areas of the brain, and to minimize the resected brain parenchyma. His seizures resolved and behavioral disorders improved, which had been impaired since age 8 years. Increased glucose metabolism in the normal frontal lobe detected by interictal fluorodeoxyglucose-positron emission tomography was correlated with the improvements in behavioral disorders. These findings suggest that the effects of seizures may be reversible in brain areas connected with, but remote from, the epileptogenic cortex.
Morino
Michiharu
M
Department of Neurosurgery, Osaka City University Graduate School of Medicine, Japan. mitchy@med.osaka-cu.ac.jp
Shimizu
Hiroyuki
H
Ishibashi
Kenichi
K
Sakamoto
Shinichi
S
Tsuyuguchi
Naohiro
N
Ohata
Kenji
K
Hara
Mitsuhiro
M
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001924:Brain Concussion / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D004569:Electroencephalography; D004834:Epilepsy, Post-Traumatic / Q000503:physiopathology / Q000601:surgery*; D004830:Epilepsy, Tonic-Clonic / Q000503:physiopathology / Q000601:surgery*; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D038421:Hemispherectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D010296:Parietal Lobe / Q000503:physiopathology / Q000601:surgery; D049268:Positron-Emission Tomography; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery*; D012920:Social Behavior Disorders / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18