Seizure outcome after functional hemispherectomy for malformations of cortical development

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Published on: April 15, 2015

M Carreño1, E Wyllie, W Bingaman

  • 1Department of Neurology, The Cleveland Clinic Foundation, OH 44195, USA.

Neurology
|July 27, 2001
PubMed

Insights

Patients with hemimegalencephaly undergoing functional hemispherectomy often have persistent seizures. However, those with preserved lobes or atrophy achieve seizure freedom, indicating differing prognoses for hemispheric malformations of cortical development.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Hemispheric malformations of cortical development (MCD) are a significant cause of intractable epilepsy.
  • Functional hemispherectomy is a surgical option for severe, focal epilepsy.
  • Predicting postsurgical seizure outcome is crucial for patient management.

Purpose of the Study:

  • To correlate magnetic resonance imaging (MRI) features with seizure outcomes after functional hemispherectomy in patients with hemispheric MCD.
  • To investigate if specific types of hemispheric MCD have different prognoses post-surgery.

Main Methods:

  • Retrospective analysis of MRI findings in patients who underwent functional hemispherectomy.
  • Correlation of preoperative MRI characteristics with seizure status at follow-up.

Main Results:

  • Five out of six (83%) patients with hemimegalencephaly experienced persistent seizures post-hemispherectomy, though improved.
  • Five out of six (83%) patients with relative lobe preservation or atrophy achieved seizure freedom.
  • MRI features indicative of hemimegalencephaly versus other MCD types showed a prognostic difference.

Conclusions:

  • Hemimegalencephaly and other hemispheric MCD types exhibit distinct seizure outcomes following functional hemispherectomy.
  • MRI-based classification of hemispheric MCD can aid in predicting postsurgical seizure control.
  • Tailoring surgical expectations based on specific MCD subtypes is essential.

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