Characterization of postoperative fevers after hemispherotomy.

Area of Science:

• Neurosurgery
• Epileptology
• Pediatric Neurology

Background:

• Hemispherotomy for intractable epilepsy often leads to postoperative fevers.
• The reasons for these fevers are not fully understood.
• Fever characteristics can vary significantly among patients.

Purpose of the Study:

• To characterize postoperative fever patterns following hemispherotomy.
• To investigate the influence of seizure etiology and ventricular drainage on fever.
• To identify factors affecting fever severity and duration.

Main Methods:

• Retrospective analysis of 72 hemispherotomy patients (1995-2013).
• Data collected included daily maximum temperature, seizure etiology, and ventricular drain use.
• Statistical analysis compared fever curves based on clinical factors.

Main Results:

• 83% of patients developed postoperative fever.
• Patients without ventricular drains experienced higher and more prolonged fevers (p=0.003).
• Rasmussen's encephalitis was associated with higher fevers, while cortical dysplasia and polymicrogyria with less severe fevers.

Conclusions:

• Postoperative fever is expected after hemispherotomy and varies with seizure etiology.
• Routine use of external ventricular drainage may mitigate fever.
• Hemispherotomy remains an effective treatment for selected intractable epilepsy cases.