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HEMISPHERECTOMY: WHY WE STILL USE IN EPILEPSY TREATMENT? TECHNICAL PITFALLS, RESULTS AND COMPLICATIONS

https://doi.org/10.17650/1683-3295-2018-20-1-56-63

Abstract

Objective is to discuss the indications, technical details, risks, complications, results and prognosis of hemispherectomy in the treatment of seizures based on critical literature review and the authors experience.

Materials and methods. It was performed bibliographical consultation from 1920 to 2016, using as keywords “seizures”, “epilepsy”, “hemispherectomy”, in the databases MEDLINE, LILACS, SciELO, PubMed, utilizing language as selection criteria, choosing preferably recent articles in Portuguese, Spanish or English and only articles based in humans studies.

Results. The functional hemispherectomy showed improvent in the quality of life of patients that has the indication to perform this procedure because it allows reducing the frequency of seizures, whether tonic or atonic, tonic-clonic. Furthermore, it has been associated to a low rates of postoperative complications, like superficial hemosiderosis, ependymitis and obstructive hydrocephalus that often it has been showed in anatomical hemispherectomy.

Conclusion. The functional hemispherectomy has been showed a significant impovement in the outcome for those with seizures arising when indicated to selected cases. However, we concluded that there is no important study comparing the functional hemispherectomy approaches with results adjusted for different causative pathologies, what would be for future necessary for an important source of data about this topic.

About the Authors

P.H. Pires de Aguiar
Santa Paula Hospital; Oswaldo Cruz Hospital; Federal University of Rio Grande do Sul; Pontifical Catholic University of São Paulo; Public Servant Hospital of São Paulo
Brazil

Division of Neurosurgery

Division of Neurosurgery

Division of Post-Graduation, Department of Surgery

Department of Neurology

Department of Neurosurgery 



B. Camporeze
Medical School of São Francisco University
Brazil


A. de Moura Lima
Public Servant Hospital of São Paulo
Brazil
Department of Neurosurgery


I.A. Estevão
Medical School of São Francisco University
Brazil


G. Matricardi
Pontifical Catholic University of São Paulo
Brazil
Department of Neurology


S. Simis
Pontifical Catholic University of São Paulo
Brazil
Department of Neurology


L. Rodrigues
Santa Paula Hospital
Brazil
Division of Neurology


R. Simm
Santa Paula Hospital
Brazil
Division of Neurology


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Pires de Aguiar P., Camporeze B., de Moura Lima A., Estevão I., Matricardi G., Simis S., Rodrigues L., Simm R. HEMISPHERECTOMY: WHY WE STILL USE IN EPILEPSY TREATMENT? TECHNICAL PITFALLS, RESULTS AND COMPLICATIONS. Russian journal of neurosurgery. 2018;20(1):56-63. https://doi.org/10.17650/1683-3295-2018-20-1-56-63

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