Hemispherotomy for pediatric epilepsy: a systematic review and critical analysis
Autor: | Alejandro J Lopez, Benjamin C. Kennedy, Clint A. Badger |
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Rok vydání: | 2021 |
Předmět: |
Drug Resistant Epilepsy
medicine.medical_specialty Hemispherectomy medicine.medical_treatment Electroencephalography 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Seizures medicine Humans Epilepsy surgery 030212 general & internal medicine Child Pediatric epilepsy Epilepsy medicine.diagnostic_test business.industry General Medicine Evidence-based medicine Treatment Outcome Epilepsy in children Pediatrics Perinatology and Child Health Etiology Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery |
Zdroj: | Child's Nervous System. 37:2153-2161 |
ISSN: | 1433-0350 0256-7040 |
Popis: | Several variations of functional disconnection surgery have been described for the treatment of lateralized, hemispheric, drug-resistant epilepsy in children. The purpose of this study is to investigate the existing literature regarding patient selection, approach, and outcomes after hemispherotomy. A systematic review of the English literature through February 2019 was performed in accordance with the PRISMA statement. The articles were classified by level of evidence and summarized in an evidentiary table. Seizure outcomes, functional outcomes, surgical techniques, complications, and patient selection were critically analyzed. A total of 173 papers were reviewed, of which 37 met criteria of inclusion and exclusion. Thirteen studies were classified as level III evidence, the remaining reached level IV. Vertical and lateral hemispherotomy achieve similar rates of seizure freedom and functional outcomes, though parasagittal and interhemispheric approaches may have shorter operative times and less blood loss. Etiology, bilateral MRI abnormalities, and nonlateralizing EEG did not predict worse seizure or functional outcomes. Both vertical and lateral hemispherotomy approaches result in durable, reproducible benefits to epilepsy severity and functional status in appropriately selected pediatric patients. |
Databáze: | OpenAIRE |
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