OP-10 Electroclinical Profile of Functional Hemispherotomy Patients and Their Surgical Outcome: A Retrospective Study

Aim: To study the electroclinical profile of patients who underwent functional hemispherotomy and their surgical outcome.

Methods: It was a retrospective study conducted at NIMS Hyderabad. Presurgical and postsurgical data of 20 patients were analyzed who underwent hemispherotomy at NIMS Hyderabad from January 2012 to December 2022. Demographic data including age, gender, duration of disease, seizure semiology, and neurological examination findings were reviewed for all the patients. VEEG findings were reviewed and analyzed in detail including IEDs, Ictal semiology, and ictal onset. Wherever applicable, MRI brain, PET CT brain, and neuropsychology data were recorded. Postoperative seizure outcomes were analyzed by Engel outcome scale at the last follow-up.

Results: Total 20 patients (13 males and 7 females) were included in the study. Mean age at seizure onset was 37.6 months. Duration of epilepsy in months before surgery ranged from 34 to 384 months. History of febrile seizure was present in 20% of the patients. All underwent vertical parasagittal hemispherotomy (right side: 11, left side: 9). Age at hemispherotomy ranged from 3 to 35 years. Fourteen out of 20 patients (70%) had good surgical outcome (Engel 1). Two patients died postoperatively. We could not find statistical significance between surgical outcome and any clinico-radiological or electrophysiological variables.

Conclusion: Refractory epilepsy owing to hemispheric pathology can be surgically treated with hemispherotomy with good outcome. Surgery for hemispheric epilepsy in the form of hemispheric resection or disconnection leads to a significant improvement in seizure control with overall better quality of life.

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Artikel online veröffentlicht:
12. September 2024