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Related Concept Videos

Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

302
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
302

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Related Experiment Video

Updated: Sep 23, 2025

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
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Seizure Outcomes and Reoperation in Surgical Rasmussen Encephalitis Patients.

Swetha J Sundar1, Elaine Lu2, Eric S Schmidt1

  • 1Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio, USA.

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|May 11, 2022
PubMed
Summary

Hemispherectomy offers excellent long-term seizure control for Rasmussen encephalitis (RE). Complete hemisphere disconnection is key, and reoperation can achieve seizure freedom in all cases.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Pediatric Neurology

Background:

  • Rasmussen encephalitis (RE) is a rare, progressive inflammatory brain condition affecting one hemisphere.
  • It leads to severe neurological deficits and intractable seizures.

Purpose of the Study:

  • To evaluate long-term seizure control and functional outcomes after hemispherectomy for RE.
  • To identify factors influencing seizure freedom and reoperation rates.

Main Methods:

  • Retrospective review of 30 patients with RE undergoing 35 hemispherectomies (1998-2020).
  • Analysis of seizure history, postoperative outcomes, and functional data.
  • Blinded review of imaging by neurosurgeons and a neuroradiologist.

Main Results:

  • Seizure-freedom rates were 81.5% (1 year), 63.6% (5 years), and 55.6% (10 years).
  • Shorter hemiparesis duration correlated with lower seizure freedom and higher reoperation risk.
  • Complete hemisphere disconnection post-surgery improved seizure outcomes and reduced reoperations.

Conclusions:

  • Complete hemisphere disconnection is crucial for favorable seizure outcomes in RE patients undergoing hemispherectomy.
  • Reoperation should be considered for recurrent seizures, as it consistently leads to seizure freedom.
  • Hemispherectomy is a highly effective, potentially curative surgery for Rasmussen encephalitis.