title: Outcomes of disconnective surgery in intractable pediatric hemispheric and subhemispheric epilepsy.
abstract: OBJECTIVE
  To study the outcome of disconnective epilepsy surgery for intractable hemispheric and sub-hemispheric pediatric epilepsy.
  
  
  METHODS
  A retrospective analysis of the epilepsy surgery database was done in all children (age <18 years) who underwent a peri-insular hemispherotomy (PIH) or a peri-insular posterior quadrantectomy (PIPQ) from April 2000 to March 2011. All patients underwent a detailed pre surgical evaluation. Seizure outcome was assessed by the Engel's classification and cognitive skills by appropriate measures of intelligence that were repeated annually.
  
  
  RESULTS
  There were 34 patients in all. Epilepsy was due to Rasmussen's encephalitis (RE), Infantile hemiplegia seizure syndrome (IHSS), Hemimegalencephaly (HM), Sturge Weber syndrome (SWS) and due to post encephalitic sequelae (PES). Twenty seven (79.4%) patients underwent PIH and seven (20.6%) underwent PIPQ. The mean follow up was 30.5 months. At the last follow up, 31 (91.1%) were seizure free. The age of seizure onset and etiology of the disease causing epilepsy were predictors of a Class I seizure outcome.
  
  
  CONCLUSIONS
  There is an excellent seizure outcome following disconnective epilepsy surgery for intractable hemispheric and subhemispheric pediatric epilepsy. An older age of seizure onset, RE, SWS and PES were good predictors of a Class I seizure outcome.
authors.affiliation: Division of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore 632004, India.
authors.forename: Santhosh George
authors.initials: SG
authors.lastname: Thomas
authors.forename: Ari George
authors.initials: AG
authors.lastname: Chacko
authors.forename: Maya Mary
authors.initials: MM
authors.lastname: Thomas
authors.forename: K Srinivasa
authors.initials: KS
authors.lastname: Babu
authors.forename: Paul Swamidhas Sudhakar
authors.initials: PS
authors.lastname: Russell
authors.forename: Roy Thomas
authors.initials: RT
authors.lastname: Daniel