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Wiley InterScience

Epilepsia

Epilepsia

Volume 46 Issue s1, Pages 30 - 31

Published Online: 3 Mar 2005

© 2010 International League Against Epilepsy



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Symposium III
Our Experience with Pediatric Epilepsy Surgery Focusing on Corpus Callosotomy and Hemispherotomy
*Hiroyuki Shimizu
  *Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
 Address correspondence and reprint requests to Dr. H. Shimizu at the Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2–6–1, Musashidai, Fuchu, Tokyo 183–0042, Japan. E-mail: smzh@tmnh.fuchu.tokyo.jp
Copyright 2005 International League Against Epilepsy
KEYWORDS
Pediatric epilepsy surgery • Corpus callosotomy • Hemispherotomy

ABSTRACT

Summary:  Purpose: In pediatric patients with intractable epilepsy, surgical intervention should be considered in terms of seizure control and prevention of neuronal deterioration. We present our experience with pediatric epilepsy surgery, focusing on corpus callosotomy and hemispherotomy.

Methods: A total of 257 pediatric patients underwent epilepsy surgeries during the last decade in our clinic. The two most common surgical procedures were corpus callosotomy and hemispherotomy. The surgical outcomes of the patients undergoing these operations were analyzed with regard to seizure outcomes and surgical complications.

Results: Corpus callosotomy proved to be extremely effective in controlling drop attacks, especially when the callosum was totally sectioned. Postoperative improvement of psychomotor function also was noticeable in >70% of the cases. In patients who underwent hemispherotomy, the etiology of unilateral hemispheric lesions was closely related to surgical results, with cases of hemimegalencephaly having the worst seizure outcome and most frequent surgical complications. Incomplete section of the callosum, one of the most important causes of residual seizures, was found in three cases.

Conclusions: In pediatric epilepsy surgery, corpus callosotomy is very effective in abolishing drop attacks and improving postoperative psychomotor function. For hemispherotomy, cases of hemimegalencephaly had the worst seizure control and surgical complications. Incomplete section of the corpus callosum should be carefully evaluated as a cause of surgical failure.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.0013-9580.2005.461009.x About DOI

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