Functional hemispherectomy in children with epilepsy and CSWS due to unilateral early brain injury including thalamus: sudden recovery of CSWS.

Abstract:

PURPOSE:To try to prove in patients with refractory symptomatic epilepsy due to early brain injury involving thalamus and complicated by CSWS the effects of the isolation of the injured hemisphere, performed with functional hemisperectomy, on epilepsy, namely on CSWS. METHODS:Full clinical follow-up before and after surgery of two cases with CSWS onset at four years in whom functional hemispherecomy was performed with resection of inter-hemispheric connections. RESULTS:An immediate effectiveness of the surgical treatment was observed on both epileptic evolution (no more seizures) and EEG abnormalities. In particular, CSWS completely disappeared, together with a concurrent progressive improving of the cognitive and behavioural disorders. DISCUSSION:The isolation of the injured hemisphere through the section of inter-hemispheric cortico-cortical connections could prevent the contralateral diffusion of discharges coming from the injured cortex and cortico-thalamic network, favouring a normal function of thalamo-cortico-thalamic circuitries in the healthy hemisphere. That could explain the disappearance of CSWS after surgery in our patients and the consequent improvement of cognitive abilities and behaviour.

journal_name

Epilepsy Res

journal_title

Epilepsy research

authors

Battaglia D,Veggiotti P,Lettori D,Tamburrini G,Tartaglione T,Graziano A,Veredice C,Sacco A,Chieffo D,Pecoraro A,Colosimo C,Di Rocco C,Dravet Ch,Guzzetta F

doi

10.1016/j.eplepsyres.2009.09.014

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

290-8

issue

2-3

eissn

0920-1211

issn

1872-6844

pii

S0920-1211(09)00258-7

journal_volume

87

pub_type

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