A novel method for confirmation of hemispheric disconnection during hemispherotomy surgery.

BACKGROUND/AIMS: Hemispherotomy has become a safe and effective surgical option for patients suffering from intractable epilepsy associated with diffuse unihemispheric malformations of cortical development. However, as compared to hemispherectomy, hemispherotomy, by leaving brain tissue behind, may leave some hemispheric connections intact, therefore increasing the risk of postoperative seizures. This is especially important to consider in the case of the highly epileptogenic hemisphere in hemimegalencephaly.

METHODS

The authors use intraoperative electroencephalography (EEG) on the ipsilateral occipital lobe and contralateral hemisphere to confirm complete hemispheric disconnection during hemispherotomy surgery.

RESULTS

This technique has been successful in the confirmation of hemispheric disconnection as no patient has had recurrence of his/her seizure postoperatively.

CONCLUSION

Intraoperative EEG may be a useful tool to confirm hemispheric disconnection during hemispherotomy.