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Why Would You Remove Half a Brain? Outcome of 58 Children after Hemispherectomy-Johns Hopkins 1968-96
Pediatrics 100:163-171, Vining,E.P.G.,et al, 1997
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Article Abstract
Perioperative death occurred in 4 out of 58 children.Of the 54 surviving children,54%(29/54)are seizure-free,24%(13/54)have nonhandicapping seizures,and 23%(12/54)have residual seizures that interfere to some extent with function.reduction in seizures was related to the etiology of the unilateral epilepsy.Eighty-nine percent of children with Rasmussen's 67%of those with dysplasias,and 67%of the vascular group are seizure-free, or have occasional,nonhandicapping seizures.All operations were considered by the parents and the physicians to have been successful in decreasing the burden of illness.In 44 the procedure was very successful,in 7 it was moderately successful,and in 3 it was minimally successful.Success was related to the etiology,and early surgery was preferable.Hemispherectomy can be a valuable procedure for relieving the burden of seizures,the burden of medication,and the general dysfunction in children with severe or progressive unilateral cortical disease.Early hemispherectomy,although increasing the hemiparesis in children with Rasmussen's syndrome,relieves the burden of constant seizures and allows the child to return to a more normal life.In children with dysplasias,early surgery can allow the resumption of more normal development.
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cortical dysplasia,focal
review article
seizure,intractable,treatment of
seizure,surgical treatment of
seizure,treatment of
Sturge-Weber syndrome
treatment of neurologic disorder

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