Long-term developmental outcome after early hemispherotomy for hemimegalencephaly in infants with epileptic encephalopathy

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• 作者：Ryoko Honda ; Takanobu Kaido ; Kenji Sugai ; Akio Takahashi ; Yuu Kaneko ; Eiji Nakagwa ; Masayuki Sasaki ; Taisuke Otsuki
• 关键词：Hemimegalencephaly ; Hemispherotomy ; Developmental outcome ; Seizure outcome ; Infant ; Epileptic encephalopathy
• 刊名：Epilepsy & Behavior
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：29
• 期：1
• 页码：30-35
• 全文大小：759 K

文摘

This study aimed to identify the effect of early hemispherotomy on development in a consecutive series of 12 infants with hemimegalencephaly (HME) demonstrating epileptic encephalopathy. Mean age at onset was 20.4 days (range, 1-140), mean age at surgery was 4.3 months (range, 2-9), and mean follow-up time was 78.8 months (range, 36-121). Eleven patients had a history of early infantile epileptic encephalopathy. Vertical parasagittal hemispherotomy was performed without mortality or severe morbidities. At follow-up, seizure freedom was obtained in 8 patients (66.7 % ), who showed significantly higher postoperative developmental quotient (DQ) (mean, 31.3; range, 7-61) than those with seizures (mean, 5.5; range, 3-8) (p = 0.02). Within the seizure-free group, postoperative DQ correlated with preoperative seizure duration (r = ? 0.811, p = 0.01). Our results showed that shorter seizure duration during early infancy could provide better postoperative DQ in infants with HME and epileptic encephalopathy.