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Peri-insular Hemispherotomy

Last Updated: September 30, 2018

Techniques of Modified Peri-Insular Hemispherotomy for Hemimegalencephaly

Indications for surgical consideration in patients with drug-resistant epilepsy include a defined epileptogenic focus and a low likelihood of new neurologic deficit after surgery. In adults, the most common etiology is temporal lobe epilepsy, that is, mesial temporal sclerosis. The most common epileptogenic etiologies in pediatric surgical candidates are low-grade tumors and malformations of cortical development.

Surgical options for pediatric patients who have marked dysfunction of a single epileptogenic hemisphere have evolved over time. Complications resulting from highly resective operations such as anatomic hemispherectomy, including superficial siderosis and secondary hydrocephalus, have led to the developm...