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Long-term P300 in hemispherectomized patients.

Xian-zeng Tong1, Yu-lun Xu, Zhuang Fu

  • 1Department of Neurosurgery, Beijing Jishuitan Hospital, Fourth Medical College of Peking University, Beijing 100035, China.

Chinese Medical Journal
|September 29, 2009
PubMed
Summary

Further modified anatomical hemispherectomy effectively controls seizures long-term in children. Neuropsychological and neurophysiological assessments revealed cognitive function comparable to controls, supporting the procedure's efficacy.

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Area of Science:

  • Pediatric Neurosurgery
  • Epileptology
  • Neuropsychology

Background:

  • Around 1990, Beijing Tiantan Hospital treated children with infantile hemiplegia and intractable epilepsy using a modified anatomical hemispherectomy.
  • This study reports the long-term follow-up of the first six pediatric cases, assessing their neuropsychological and neurophysiological status.
  • Patients were evaluated a median of 17.8 years post-hemispherectomy.

Purpose of the Study:

  • To evaluate the long-term seizure control and cognitive function in children who underwent hemispherectomy.
  • To assess the neuropsychological and neurophysiological status of these patients using event-related potentials (ERPs).
  • To affirm the long-term curative effects of the modified anatomical hemispherectomy.

Main Methods:

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  • Neuropsychological and neurophysiological measurements were conducted on six patients and a normal control group.
  • An oddball task was used to collect P300 event-related potentials (ERPs), measuring peak latency (PL) and peak amplitude (PA).
  • Baseline characteristics and long-term follow-up data, including seizure control and cognitive function, were analyzed.

    • Main Results:

    • Five of the six patients achieved complete seizure remission, and one was nearly seizure-free post-surgery.
    • Clear P300 potentials were obtained in all patients, with no statistically significant differences in P300 compared to the control group.
    • Maximum P300 amplitude occurred at electrode sites Pz or Cz, consistent with control group findings and previous research.

    Conclusions:

    • Further modified anatomical hemispherectomy demonstrates favorable long-term antiepileptic effects.
    • The P300 results indicate that the basic cognitive functions of hemispherectomized patients are comparable to those of healthy individuals.
    • These findings underscore the brain's plasticity and support the long-term efficacy of this surgical procedure from both neuropsychological and neurophysiological perspectives.