A novel method for confirmation of hemispheric disconnection during hemispherotomy surgery.
OBJECTIVE
Hemispherotomy has become a safe and effective surgical option for patients suffering from intractable epilepsy associated with diffuse unihemispheric malformations of cortical development. However, as compared to hemispherectomy, hemispherotomy, by leaving brain tissue behind, may leave some hemispheric connections intact, therefore increasing the risk of postoperative seizures. This is especially important to consider in the case of the highly epileptogenic hemisphere in hemimegalencephaly.


METHODS
The authors use intraoperative electroencephalography (EEG) on the ipsilateral occipital lobe and contralateral hemisphere to confirm complete hemispheric disconnection during hemispherotomy surgery.


RESULTS
This technique has been successful in the confirmation of hemispheric disconnection as no patient has had recurrence of his/her seizure postoperatively.


CONCLUSIONS
Intraoperative EEG may be a useful tool to confirm hemispheric disconnection during hemispherotomy.
Kim
Daniel L
DL
Clarian Neuroscience, Indiana University, Indianapolis, IN 46202, USA.
Osburn
Leisha L
LL
Cohen-Gadol
Aaron A
AA
D000293:Adolescent; D003337:Corpus Callosum / Q000601:surgery; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D038421:Hemispherectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016343:Monitoring, Intraoperative / Q000379:methods*