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- W2888891580 abstract "Objective: Functional hemispherectomy (FH) represents the gold standard surgical treatment in intractable hemispheric epilepsy reporting on four etiologies: hemispheric cortical dysplasia (HCD) including hemimegalencephaly, Sturge Weber (SW) syndrome presenting with hemispheric pial angioma, vascular ischemic sequelae (V-Isch) and Rasmussen encephalitis (RE). The long term outcome is almost reported according to the seizure rate but not considering the other impacts of surgery. In this study, we focused on the verbal long term outcome of these patients growing and living with one isolated hemisphere. Methods: From 1990 to 2014, 261 children underwent the same FH surgical procedure (Vertical Parasagittal Hemispherotomy) at our institution: HCD (43%), SW (13%), V-Isch (21%) RE (23%). Verbal intellectual abilities was determined in the 201 patients with French language using standardized developmental or Wechsler scales or Vineland Adaptive behavioral scale (VABS) when the patient was unable to participate to evaluation. Results: Overall, 72 % (144/201) obtained verbal intellectual deficiency determined as a score lower than 70. The percentage of verbal mental retardation varied according to etiologies with higher rate being obtained in HCD (85%), V-Isc (74%) SW (72%) as compared to RE (43%). Standardized scale was performed in 81% of the patient using age appropriate scale (52%) or lower (48%). VABS was used in the 29% of the patient who were not testable. Verbal communication was however possible for everyday life and only a minority of patients remained mute after surgery. We analyzed these results according to the prognosis factors: age of seizure onset, duration of seizure, etiologies, side of surgery, postoperative follow-up, Engel score and contralateral MRI abnormalities. Conclusion: FH is a recommended surgical treatment for intractable hemispheric epilepsy since the majority of patients become seizure–free after surgery. The majority of patients are able to communicate using verbal channel but only 28% of them develop normal language abilities." @default.
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- W2888891580 date "2017-06-01" @default.
- W2888891580 modified "2023-10-01" @default.
- W2888891580 title "Verbal intellectual abilities long term outcome after Vertical Parasagittal Hemispherotomy: The Rothschild foundation hospital experience" @default.
- W2888891580 doi "https://doi.org/10.1016/j.ejpn.2017.04.721" @default.
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