Hemispherotomy for isolated infantile spasms following perinatal ischemic stroke. (September 2015)

• Record Type: Journal Article
• Authors: Taussig, Delphine; Dorfmüller, Georg; Save, Jessica; Fohlen, Martine; Chipaux, Mathilde; Ferrand-Sorbets, Sarah; Delalande, Olivier; Bulteau, Christine
• Is Part Of: European journal of paediatric neurology. Volume 19:Number 5(2015:Sep.)
• Page Start: 597
• Page End: 602
• Publication Date: 2015-09
• Subjects: Pediatric neurology -- Periodicals; Nervous System Diseases -- Periodicals; Child -- Periodicals; Infant -- Periodicals; Neurologie pédiatrique -- Périodiques; Pediatric neurology; Electronic journals; Periodicals; Electronic journals; 618.928
• DOI: 10.1016/j.ejpn.2015.04.003
• Languages: English
• ISSNs: 1090-3798

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015a">Background</title> <p id="abspara0010a">Infantile spasms (IS) are a severe epileptic encephalopathy. In patients with early focal ischemia and refractory IS, a preoperative evaluation is required even if IS are the only ictal manifestation.</p> </sec> <sec> <title id="sectitle0020a">Methods</title> <p id="abspara0015a">We report three such patients who presented with IS between 5 and 7 months of age without any other focal seizure types. Imaging exhibited a perinatal middle cerebral artery (MCA) stroke.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0025q">All patients had hemiparesis and experienced psychomotor regression after the onset of IS. Scalp video-electroencephalogram (EEG) monitoring for presurgical assessment showed interictal and ictal EEG characteristics between the pathological and the healthy hemisphere and surgery was proposed despite the lack of any focal seizures. The three patients underwent hemispherotomy at a mean age of 27 months and became seizure-free without medication (follow-up 49–144 months). The two patients who underwent early hemispherotomy acquired normal verbal intelligence, whereas the third, operated on at 38 months of age, remained with severe mental retardation.</p> </sec> <sec> <title id="sectitle0030a">Conclusion</title> <p id="abspara0025a">Early hemispherotomy in drug-resistant epilepsy related to a perinatal MCA may cure the seizures even if the patient has IS as sole type and prevent mental retardation in some children.</p> </sec> </abstract>