Hemispherectomy for intractable seizures: a further modification and early experience

Hemispherectomy is well recognized as an effective treatment for some types of intractable epilepsy, but the procedure is also known to be associated with significant late complications. A number of modifications to the original operation have been developed to try and minimize such late complications. These are reviewed and a further modification is described using a Zenoderm graft to isolate the hemispherectomy cavity from the remaining CSF pathways. We present our early experience with this new modification in seven patients with intractable epilepsy.