Hemispherectomy in Children: Seizure Recurrence and Outcome Predictors

A prospective study shows that hemispherectomy is an effective surgical option for children with medically refractory epilepsy with multilobar or hemispheric lesions and provides for realistic prognostication on seizure outcomes.

To improve understanding of hemispherectomy outcomes in children with medically refractory epilepsy, researchers prospectively studied 170 children who underwent hemispherectomy at one institution over a 12-year period.

Median follow-up was 5.3 years. Of the cohort, 66% were seizure-free at last follow-up after surgery, and another 14% achieved a favorable outcome (>90% seizure reduction). On univariate analysis, bilateral positron emission tomography (PET) abnormalities, nonlateralized onset on electroencephalography (EEG), history of hemispheric surgery, and acute (7-day) postoperative seizure correlated with seizure recurrence after surgery. Multivariate analysis showed that bilateral PET abnormalities and acute postoperative seizures wer…

Reviewing Author

Nilika Shah Singhal, MD