Intractable Epilepsia in Pediatric Populations: Surgical Approaches, Results, and Therapy, A Comprehensive Systematic Review of the Literature in Hemispherectomy

Yıl 2024, Cilt: 11 Sayı: 2, 78 - 87, 30.08.2024

Daniel Encarnacion-santos Gennady Chmutin Ismail Bozkurt Jack Wellington Aysi Gordon Gullanyi Bipin Chaurasia

https://doi.org/10.32739/uha.jnbs.11.1515326

Öz

A hemispherectomy is a surgical procedure in which the basal ganglia are retained but the entire cerebral hemisphere is removed. This technique was used by Dandy in 1928 to remove a glioma. McKenzie, a Canadian doctor, performed the first hemispherectomy on an epileptic patient in 1938. A comprehensive review of the scientific literature was carried out using the recommended guidelines. Using PRISMA (Preferred Reporting Items for Systematic Reviews) guidelines, this study carefully evaluated the scholarly literature on surgical outcomes and treatment regimens. We followed the EXCEL criteria, Rayyan (Intelligent Systematic Review), and R software. Academic publications were found in databases such as ScienceDirect and PubMed/MEDLINE Studies published in English up until January 2024. Our study of epileptic patients with intractable epilepsy involved a total of 1157 patients, of whom 708 underwent hemispherectomy. Table 1-2-3, and Figure 2,3,4, 5show the patients' demographic breakdown: 195 patients, or 27.54%, had cortical dysplasia, seizures, or Rasmussen encephalitis; 305 patients, or 43.08%, had seizures; 87 patients, or 12.29%, had strokes or Weber syndrome; 449 patients, or 72.8% of the patients, out of 325 patients, had the Engel type 1 classification; and 232 patients, or 51.67% of the patients, had Engel type 2. The results of this pediatric systematic review led us to the conclusion that, once an infant's nonexistent seizure count is reached, either through conservative or immunoregulatory therapy or brain stimulation, hemispherectomy is the most stable course of action. Intractable epilepsy is essentially treatable.

Anahtar Kelimeler

Intractable Epilepsia, Hemispherectomy, Disconnections, Syndromes, outcomes and treatments.

Kaynakça

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