title: Anatomic hemispherectomy for intractable epilepsy in a patient with unilateral schizencephaly.
abstract: Schizencephaly is a rare congenital cortical brain malformation defined by unilateral or bilateral clefts of the cerebral hemispheres. These malformations are often associated with medically intractable epilepsy. Surgical solutions include lesionectomy, lobectomy, or hemispherectomy. The authors describe the case of an anatomic hemispherectomy for medically intractable epilepsy in an 8-year-old boy with a large schizencephalic cleft. Seven years prior to his epilepsy surgery, the patient underwent placement of a ventriculoperitoneal shunt for communicating hydrocephalus that resulted in severe left-to-right shift. Subsequently, medically refractory epilepsy developed and the patient underwent an anatomic hemispherectomy for seizure control. The preoperative brain shift remained after the surgery, although the patient tolerated the procedure well and was seizure free postoperatively. Anatomic hemispherectomy is a viable option for treating medically intractable epilepsy in a schizencephalic pediatric patient-even one with considerable brain shift.
authors.affiliation: Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104-4399, USA.
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Heuer
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Hardesty
authors.forename: Kareem A
authors.initials: KA
authors.lastname: Zaghloul
authors.forename: Erin M
authors.initials: EM
authors.lastname: Simon Schwartz
authors.forename: A Reghan
authors.initials: AR
authors.lastname: Foley
authors.forename: Phillip B
authors.initials: PB
authors.lastname: Storm
mesh_terms: D002648:Child; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D038421:Hemispherectomy; D006801:Humans; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications* / Q000473:pathology* / Q000601:surgery