Yuguang Guan1, Jian Zhou, Guoming Luan, Xingzhou Liu. 1. Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, and Beijing Key Laboratory in Epilepsy, Beijing, China.
Abstract
BACKGROUND: Rasmussen encephalitis (RE) is a rare progressive encephalitis that results in intractable seizures, cognitive decline and hemiparesis. Surgery seems to be the only effective way to control seizures in RE patients. OBJECTIVE: To describe the clinical, electrophysiological, neuroradiological and histological findings of our patients with RE and to evaluate the outcome of their surgical treatment. METHODS: A total of 20 patients were identified by the criteria of RE. Surgery was conducted in the left hemisphere in 6 patients and in the right hemisphere in 14. The surgical methods included anatomical hemispherectomy, functional hemispherectomy, hemispherotomy, lesion resection, multilobar resection, selective resection and bipolar electrocoagulation of functional cortexes. RESULTS: The mean follow-up period was 5.45 years (range 3-8). After surgery, 16 patients (80%) were evaluated as being Engel class I. All of the patients had increases in cognitive abilities after surgery except 1 patient with bilateral RE. After surgery, most patients could walk independently, but the fine movement of the hands was lost. Postoperative hydrocephalus was observed in 1 patient after functional hemispherectomy, and there was no death in this series. CONCLUSION: Hemispherectomy and hemispherotomy were both confirmed as beneficial procedures in controlling seizures and improving quality of the life in RE cases.
BACKGROUND: Rasmussen encephalitis (RE) is a rare progressive encephalitis that results in intractable seizures, cognitive decline and hemiparesis. Surgery seems to be the only effective way to control seizures in RE patients. OBJECTIVE: To describe the clinical, electrophysiological, neuroradiological and histological findings of our patients with RE and to evaluate the outcome of their surgical treatment. METHODS: A total of 20 patients were identified by the criteria of RE. Surgery was conducted in the left hemisphere in 6 patients and in the right hemisphere in 14. The surgical methods included anatomical hemispherectomy, functional hemispherectomy, hemispherotomy, lesion resection, multilobar resection, selective resection and bipolar electrocoagulation of functional cortexes. RESULTS: The mean follow-up period was 5.45 years (range 3-8). After surgery, 16 patients (80%) were evaluated as being Engel class I. All of the patients had increases in cognitive abilities after surgery except 1 patient with bilateral RE. After surgery, most patients could walk independently, but the fine movement of the hands was lost. Postoperative hydrocephalus was observed in 1 patient after functional hemispherectomy, and there was no death in this series. CONCLUSION: Hemispherectomy and hemispherotomy were both confirmed as beneficial procedures in controlling seizures and improving quality of the life in RE cases.
Authors: Swetha J Sundar; Elaine Lu; Eric S Schmidt; Efstathios D Kondylis; Deborah Vegh; Matthew J Poturalski; Juan C Bulacio; Lara Jehi; Ajay Gupta; Elaine Wyllie; William E Bingaman Journal: Neurosurgery Date: 2022-05-13 Impact factor: 5.315
Authors: Justin R Bingaman; Swetha J Sundar; Jason K Hsieh; Elaine Lu; Lara Jehi; Elaine Wyllie; Ajay Gupta; Richard Prayson; William E Bingaman Journal: World Neurosurg Date: 2022-03-17 Impact factor: 2.210