Hemispheric surgery for refractory epilepsy in children and adolescents: Outcome regarding seizures, motor skills and adaptive function

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dc.contributor.authorHamad, Ana Paula Andrade [UNIFESP]
dc.contributor.authorCaboclo, Luís Otávio Sales Ferreira [UNIFESP]
dc.contributor.authorCenteno, Ricardo Silva [UNIFESP]
dc.contributor.authorCosta, Livia Vianez [UNIFESP]
dc.contributor.authorLadeia-Frota, Carol [UNIFESP]
dc.contributor.authorCarrete Junior, Henrique [UNIFESP]
dc.contributor.authorGomez, Nicolas Garofalo
dc.contributor.authorMarinho, Murilo Martinez [UNIFESP]
dc.contributor.authorYacubian, Elza Márcia Targas [UNIFESP]
dc.contributor.authorSakamoto, Américo Ceiki [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionInst Neurol & Neurocirugia Cuba
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.date.accessioned2016-01-24T14:34:36Z
dc.date.available2016-01-24T14:34:36Z
dc.date.issued2013-11-01
dc.description.abstractPurpose: the aim of the study was to report the seizure outcome, motor skills and adaptive motor functions in a series of children and adolescents who underwent hemispheric surgery, analysing the risk-benefits of surgery.Methods: the clinical course, seizure and motor function outcomes of 15 patients who underwent hemispheric surgery were reviewed.Results: the mean age at surgery was 9.5, with 1-9 years follow-up. the underlying pathologies were Rasmussen encephalitis, vascular disorders, and hemimegalencephaly. All the patients presented with severe epilepsy and different degrees of hemiparesis, although motor functionality was preserved in 80% of the patients. At last follow-up, 67% were seizure free, and 20% rarely experienced seizures. Antiepileptic drugs were reduced in 60%, and complete withdrawal from such drugs was successful in 20% of the patients. the motor outcome following the surgery varied between the patients.Despite the motor deficit after surgery, the post-operative motor function showed unchanged for gross motor function in most (60%), while 27% improved. Similar results were obtained for the ability to handle objects in daily life activities. Sixty percent of the children were capable of handling objects, with somewhat reduced coordination and/or motor speed.Conclusion: Pre-surgical motor function continues to play a role in the pre-surgical evaluation process in order to provide a baseline for outcome. Hemispheric surgery, once regarded as a radical intervention and last treatment resource, may become routinely indicated for refractory hemispheric epilepsy in children and adolescents, with oftentime favourable motor outcomes. (C) 2013 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, Hosp São Paulo, Dept Neurol & Neurocirurgia, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Diagnost Imagem, São Paulo, Brazil
dc.description.affiliationInst Neurol & Neurocirugia Cuba, Dept Neuropediat, Havana 10400, Cuba
dc.description.affiliationUniv São Paulo, Fac Med Ribeirao Preto, Dept Neurociencias & Ciencias Comportamento, BR-14049 Ribeirao Preto, SP, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Hosp São Paulo, Dept Neurol & Neurocirurgia, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Diagnost Imagem, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent752-756
dc.identifierhttp://dx.doi.org/10.1016/j.seizure.2013.06.001
dc.identifier.citationSeizure-european Journal of Epilepsy. London: W B Saunders Co Ltd, v. 22, n. 9, p. 752-756, 2013.
dc.identifier.doi10.1016/j.seizure.2013.06.001
dc.identifier.fileWOS000326145900014.pdf
dc.identifier.issn1059-1311
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/36896
dc.identifier.wosWOS:000326145900014
dc.language.isoeng
dc.publisherW B Saunders Co Ltd
dc.relation.ispartofSeizure-european Journal of Epilepsy
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectEpilepsyen
dc.subjectChildrenen
dc.subjectHemispheric surgeryen
dc.subjectMotor functionen
dc.subjectOutcomeen
dc.subjectFollow-upen
dc.subjectImpairmenten
dc.titleHemispheric surgery for refractory epilepsy in children and adolescents: Outcome regarding seizures, motor skills and adaptive functionen
dc.typeinfo:eu-repo/semantics/article
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