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Endoscopic Hemispherotomy for Nonatrophic Rasmussen's Encephalopathy
Ramesh Sharanappa Doddamani1, P Sarat Chandra1, Raghu Samala1
1Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Neurology India
|September 11, 2021
Summary
Endoscopic hemispherotomy offers a minimally invasive and effective surgical option for severe epilepsy, leading to seizure freedom in patients with conditions like Rasmussen's encephalitis.
Area of Science:
- Neurosurgery
- Epileptology
- Minimally Invasive Surgery
Background:
- Hemispheric disconnection is a major epilepsy surgery for intractable hemispheric pathologies.
- Techniques have evolved from anatomical hemispherectomy to minimally invasive functional disconnections.
- Conditions like Rasmussen's encephalitis benefit from these procedures.
Observation:
- A 12-year-old girl with drug-resistant epilepsy presented with complex focal seizures.
- Video electroencephalography and serial MRI indicated progressive left hemispheric changes consistent with Rasmussen's encephalitis.
Findings:
- The patient underwent a left-sided endoscopic hemispherotomy using an interhemispheric approach.
- At 2-year follow-up, the patient achieved complete seizure freedom (International League Against Epilepsy Class 1).
Implications:
- Endoscopic hemispherotomy is a safe, reproducible, and effective technique for treating severe hemispheric epilepsy.
- This minimally invasive approach offers excellent seizure control for select pediatric epilepsy patients.
