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Updated: Apr 29, 2026
Author Spotlight: Studying Clinical Characters and Epilepsy Outcomes After Frontal Disconnection in Patients with MOGHE
Published on: August 16, 2024
Long-term outcomes of hemispheric disconnection in pediatric patients with intractable epilepsy
Yun-Jeong Lee1, Eun-Hee Kim1, Mi-Sun Yum1
1Division of Pediatric Neurology, Department of Pediatrics, Asan Medical Center Children's Hospital, Seoul, Korea.
Insights
Pediatric hemispherectomy offers good seizure control and improved quality of life for children with intractable hemispheric epilepsy. Most patients experienced seizure freedom and maintained or improved motor and cognitive functions post-surgery.
Area of Science:
- Pediatric Neurosurgery
- Epileptology
- Pediatric Neurology
Background:
- Hemispherectomy is a recognized treatment for medically intractable hemispheric epilepsy in children.
- This procedure aims to improve seizure outcomes and quality of life.
Purpose of the Study:
- To review neuroradiologic and pathologic findings in pediatric hemispherectomy patients.
- To evaluate epilepsy characteristics and long-term clinical outcomes following hemispheric disconnection.
Main Methods:
- Retrospective study of 12 pediatric patients who underwent hemispherectomy between 1997 and 2005.
- Data collected included clinical, EEG, neuroradiological, and surgical details.
- Long-term outcomes assessed seizure control, motor, and cognitive functions at a mean follow-up of 12.7 years.
Main Results:
- Epilepsy onset averaged 3.0 years; common diagnoses included focal symptomatic epilepsy, West syndrome, and Rasmussen's syndrome.
- Histopathology revealed cortical malformations, encephalomalacia, Sturge-Weber syndrome, and Rasmussen's encephalitis.
- 66.7% of patients achieved seizure freedom; no new motor or cognitive deficits were observed, with most improving functional abilities.
Conclusions:
- Hemispherectomy demonstrates favorable long-term clinical outcomes in pediatric patients with intractable hemispheric epilepsy.
- Careful patient selection and skilled surgical techniques are crucial for successful outcomes.
Background And Purpose:
Hemispherectomy reportedly produces remarkable results in terms of seizure outcome and quality of life for medically intractable hemispheric epilepsy in children. We reviewed the neuroradiologic findings, pathologic findings, epilepsy characteristics, and clinical long-term outcomes in pediatric patients following a hemispheric disconnection.
Methods:
We retrospectively studied 12 children (8 males) who underwent a hemispherectomy at Asan Medical Center between 1997 and 2005. Clinical, EEG, neuroradiological, and surgical data were collected. Long-term outcomes for seizure, motor functions, and cognitive functions were evaluated at a mean follow-up of 12.7 years (range, 7.6-16.2 years) after surgery.
Results:
The mean age at epilepsy onset was 3.0 years (range, 0-7.6 years). The following epilepsy syndromes were identified in our cohort: focal symptomatic epilepsy (n=8), West syndrome (n=3), and Rasmussen's syndrome (n=1). Postoperative histopathology of our study patients revealed malformation of cortical development (n=7), encephalomalacia as a sequela of infarction or trauma (n=3), Sturge-Weber syndrome (n=1), and Rasmussen's encephalitis (n=1). The mean age at surgery was 6.5 years (range, 0.8-12.3 years). Anatomical or functional hemispherectomy was performed in 8 patients, and hemispherotomy was performed in 4 patients. Eight of our 12 children (66.7%) were seizure-free, but 3 patients with perioperative complications showed persistent seizure. Although all patients had preoperative hemiparesis and developmental delay, none had additional motor or cognitive deficits after surgery, and most achieved independent walking and improvement in daily activities.
Conclusions:
The long-term clinical outcomes of hemispherectomy in children with intractable hemispheric epilepsy are good when careful patient selection and skilled surgical approaches are applied.
