EEG prior to hemispherectomy: correlation with outcome and pathology

Electroencephalography and Clinical Neurophysiology
L CarmantG L Holmes

Abstract

Hemispherectomy, for the treatment of seizures, is highly successful but has a significant morbidity rate. The procedure is usually restricted to patients with an intractable seizure disorder and hemiparesis. Because of the inherent risk of surgery, patient selection is a critical issue. This report describes the evaluation of background activity and ictal patterns on surface and invasive EEG in 12 children who underwent both anatomical (7) and functional (5) hemispherectomy in order to determine the role of electroencephalography in the selection of patients for hemispherectomy, and to correlate EEG findings with underlying pathology and outcome. A favorable outcome was predicted by an interictal EEG with two or more of the following: suppression over the abnormal hemisphere, absence of contralateral slowing, absence of generalized discharges and absence of bilateral independent spiking; or by unilateral onset of ictal discharges on invasive intracerebral EEG recording. Outcome did not correlate with the underlying pathology. Hemispherectomy can be successful in patients with a variety of predominantly unilateral pathologic entities.

References

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Citations

Jun 29, 2006·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jean-Guy Villemure, Roy Thomas Daniel
May 1, 1997·Electroencephalography and Clinical Neurophysiology·R A WennbergJ G Villemure
Feb 1, 1997·Seizure : the Journal of the British Epilepsy Association·N AdachiT Hisano
Jul 17, 2010·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Chaturbhuj Rathore, Kurupath Radhakrishnan
Sep 2, 2008·Neurosurgical Focus·Sandrine De Ribaupierre, Olivier Delalande
Jul 17, 2004·Journal of Neurosurgery·Aaron A Cohen-GadolDennis D Spencer
Jan 21, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Vera C Terra-BustamanteAmérico C Sakamoto
Aug 5, 2011·Seizure : the Journal of the British Epilepsy Association·Hansel M GreinerKi-Hyeong Lee
Nov 8, 2014·Journal of Neurosurgery. Pediatrics·Christoph J GriessenauerPeter A Winkler
Feb 1, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ananth P AbrahamAri G Chacko
May 29, 2000·Brain : a Journal of Neurology·S M Sisodiya

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