title: Functional Hemispherectomy for Refractory Status Epilepticus in 2 Adults.
abstract: BACKGROUND
  Status epilepticus (SE) is a medical emergency, as deleterious long-term effects are well known. Medically induced burst suppression is often required if first-line and second-line treatments fail. Surgical intervention can be considered in some patients after prolonged treatment failure of medically induced coma. Multiple surgical options for terminating SE have been demonstrated in the literature, with only 2 reports including hemispherectomy in adults.
  
  
  METHODS
  We present 2 cases of adults with refractory SE who failed more conservative medical/surgical treatment but responded to functional hemispherectomy. Pertinent electroencephalography and imaging findings are discussed. In addition, all previously published pediatric and adult cases are briefly reviewed.
  
  
  CONCLUSIONS
  Functional hemispherectomy can be considered in patients, including adults, with super-refractory SE and diffuse hemispheric onset. We report acceptable outcomes and quality of life in our 2 patients.
authors.affiliation: Department of Neurosurgery, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA. Electronic address: McGinity@uthscsa.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: McGinity
authors.affiliation: Department of Neurosurgery, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Andrade
authors.affiliation: Department of Neurology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA; South Texas Comprehensive Epilepsy Center, San Antonio, Texas, USA.
authors.forename: Kameel
authors.initials: K
authors.lastname: Karkar
authors.affiliation: Department of Neurosurgery, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA; South Texas Comprehensive Epilepsy Center, San Antonio, Texas, USA.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Caron
authors.affiliation: Department of Neurosurgery, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA; Department of Neurology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA; South Texas Comprehensive Epilepsy Center, San Antonio, Texas, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Szabó
authors.affiliation: Department of Neurosurgery, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA; South Texas Comprehensive Epilepsy Center, San Antonio, Texas, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Papanastassiou
mesh_terms: D000328:Adult; D038421:Hemispherectomy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D020127:Recovery of Function; D013226:Status Epilepticus / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome
keywords: EEG; Epilepsy; Hemispherectomy; Neurosurgery; Seizure; Status epilepticus