Functional Hemispherectomy for Refractory Status Epilepticus in 2 Adults

Area of Science:

• Neurosurgery
• Epileptology

Background:

• Status epilepticus (SE) is a critical neurological emergency with significant long-term consequences.
• Refractory SE often necessitates medically induced coma and, in persistent cases, surgical intervention.
• Hemispherectomy is a rarely reported surgical option for SE, particularly in adults.

Observation:

• This study details two adult cases of refractory SE who underwent functional hemispherectomy after failing conventional treatments.
• Electroencephalography and imaging data were analyzed to understand treatment response.
• A review of existing literature on hemispherectomy for SE in pediatric and adult populations was conducted.

Findings:

• Functional hemispherectomy proved effective in terminating SE in both adult patients presented.
• Patients achieved acceptable neurological outcomes and maintained a good quality of life post-surgery.
• The review indicated limited prior adult cases but supported hemispherectomy as a potential treatment.

Implications:

• Functional hemispherectomy should be considered for adult patients with super-refractory SE and diffuse hemispheric onset.
• This surgical approach may offer a life-altering solution for intractable epilepsy cases.
• Further research into the long-term efficacy and safety of hemispherectomy for SE is warranted.