Hemispherotomy in Adults. Is It Safe?—A Prospective Observational Study in Comparison to Children

Introduction: Hemispherotomy (HS) is a safe and effective procedure for drug-resistant epilepsy in appropriately selected patients. There are few publications for HS in adults with less than 100 patients reported till date. This series compares the HS in adults and pediatric age groups, which is first of its kind.

Methods: Data were prospectively collected for HS patients during April 2014 to August 2017. Cutoff age was 18 years. Comparison between the groups was done for seizure onset, duration of epilepsy, frequency of seizures, number of drugs, intraoperative blood loss, postoperative seizure control postoperative stay, postoperative motor functions, and preoperative and postoperative intelligence quotient.

Results: Total 55 pediatric and nine adults underwent HS. The seizure onset was earlier in children and duration of epilepsy was longer in adults. The frequency of seizures per day was 14.62 ± 2.57 in children, while in adults was 7.71 ± 5.21 per day, with the p-value of 0.49. Mean number of drugs was similar in the preoperative and postoperative periods in both. In this study, 85.5% of children and 88.9% of adults had class I seizure outcome (p = —0.59). Blood loss and postoperative stay were similar in both the groups. No patient had permanent motor deficit. There was transient worsening of power in one pediatric patient and in four adult patients. IQ remained same in both the groups. One adult patient had meningitis and another had hydrocephalous requiring shunt placement.

Conclusion: Hemispherotomy is as safe and effective procedure in adults as in children in appropriately selected patients.