Post-operative progress of patients with Rasmussen's encephalitis who have undergone hemispherotomy surgery

Post-operative progress of patients with Rasmussen's encephalitis who have undergone hemispherotomy surgery

Title: Post-operative progress of patients with Rasmussen's encephalitis who have undergone hemispherotomy surgery;
Evolución posquirúrgica en pacientes con encefalitis de Rasmussen operados por hemisferotomía
Author Garofalo-Gomez, Nicolas Google Scholar
Hamad, Ana Paula Andrade Autor UNIFESP Google Scholar
Centeno, Ricardo Silva Autor UNIFESP Google Scholar
Ferrari, Taissa Pinheiro Fernandes Autor UNIFESP Google Scholar
Carrete Junior, Henrique Autor UNIFESP Google Scholar
Caboclo, Luis Otavio Sales Ferreira Autor UNIFESP Google Scholar
Yacubian, Elza Márcia Targas Autor UNIFESP Google Scholar
Institution Inst Neurol & Neurocirugia
Universidade Federal de São Paulo (UNIFESP)
Abstract Introduction. Rasmussen's encephalitis (RE) is a progressive pathology affecting the brain that causes unilateral hemispheric atrophy, neurological dysfunction and refractory epilepsy. Hemispherotomy is considered the most effective treatment today, but some cases present certain peculiarities that can seriously affect the decision to go ahead with this procedure.Aims. To evaluate the post-operative progress made by children with RE who have undergone hemispherotomy surgery, and who, in the pre-operative assessment, presented certain characteristics that complicated the decision to perform surgery.Patients and methods. The sample selected for study consisted of the cases of RE attended in the Hospital Sao Paulo between 2003 and 2012 who, in the pre-surgery evaluation, presented clinical, electroencephalographic or neuroimaging evidence of involvement of both brain hemispheres, compromise of the dominant brain hemisphere, absence of severe neurological deficit and absence of criteria for refractory epilepsy and atypical crises. The post-operative assessment of the epileptic seizures was evaluated using the Engel scale; motor function was analysed with the Gross Motor Function Classification System and Manual Ability Classification System scales, and language was evaluated clinically.Results. Six cases were selected (four girls), with a mean age at clinical onset of 3.3 +/- 1.2 years (range: 2-7 years) and a mean age at hemispherotomy of 6.7 years (range: 2.3-16.5 years). The mean post-surgery follow-up time was three years (range: 0.5-7.2 years). In the post-surgery evaluation of the epileptic seizures, four cases were classified as Engel class I (66%); there was some improvement in motor functioning in five of them, and language improved in all cases.Conclusions. Hemispherotomy must be considered an efficient option for treatment in children with RE.
Keywords Children
Motor function
Quality of life
Rasmussen's encephalitis
Language Spanish
Date 2013-02-16
Published in Revista De Neurologia. Barcelona: Revista De Neurologia, v. 56, n. 4, p. 214-219, 2013.
ISSN 0210-0010 (Sherpa/Romeo, impact factor)
Publisher Revista De Neurologia
Extent 214-219
Access rights Closed access
Type Article
Web of Science ID WOS:000315747200004

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