Endoscopic Hemispherotomy for Nonatrophic Rasmussen's Encephalopathy

Autor:	Ramesh Doddamani, Ajay Garg, Madhavi Tripathi, Shailesh Gaikwad, Manjari Tripathi, Chandrashekhar Bal, Bhargavi Ramanujan, Raghu Samala, P. Sarat Chandra
Rok vydání:	2021
Předmět:	Hemimegalencephaly medicine.medical_specialty Hemispherectomy Aura medicine.medical_treatment Encephalopathy Seizure onset Medicine Humans Ictal Child Epilepsy business.industry Video electroencephalography Electroencephalography medicine.disease Magnetic Resonance Imaging Surgery Treatment Outcome Neurology Female Neurology (clinical) Disconnection business
Zdroj:	Neurology India. 69(4)
ISSN:	1998-4022
Popis:	Background: Hemispheric disconnection represents a challenging and major epilepsy surgical procedure. This procedure in experienced hands offers excellent results in terms of seizure outcomes, especially for hemispheric pathologies such as Rasmussen's encephalitis, hemispheric dysplasias, hemimegalencephaly. The technique of hemispherotomy has witnessed various modifications over the years, beginning from anatomical hemispherectomy to the current era of minimally invasive functional hemispheric disconnections. Objective: This study aimed to describe the technique of performing endoscopic vertical hemispherotomy using interhemispheric corridor developed by the senior author. Materials and Methods: A 12-year-old girl with seizure onset at the age of 10 years presented with an aura of fear and nausea followed by tonic deviation of eyes to the right and blinking with speech arrest. There were tonic–clonic movements of the right-sided limbs along with ictal spitting and occasional deviation of the angle of mouth to the right. The patient had loss of awareness for the event along with postictal confusion lasting few minutes. Results: Video electroencephalography (VEEG) revealed left parietocentral and left temporal localization. Serial magnetic resonance imaging (MRI) brain over 3 years revealed progressive left hemispheric changes suggestive of Rasmussen's encephalitis. The patient underwent left-sided endoscopic hemispherotomy. At 2 years follow-up, the patient is seizure-free (ILAE [International League Against Epilepsy] Class 1). Conclusion: Endoscopic hemispherotomy using the interhemispheric approach is an elegant, minimally invasive, reproducible, safe, and efficacious technique.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0bd03ad066f58733b1ca4a58a0f04f44 https://pubmed.ncbi.nlm.nih.gov/34507398 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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