• World Neurosurg · Sep 2016

    Case Reports

    Functional hemispherectomy for refractory status epilepticus in two adults.

    • Michael McGinity, Nicholas Andrade, Kameel Karkar, Jean-Louis Caron, Charles Szabó, and Alexander Papanastassiou.
    • Department of Neurosurgery, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA. Electronic address: McGinity@uthscsa.edu.
    • World Neurosurg. 2016 Sep 1; 93: 489.e11-6.

    BackgroundStatus epilepticus (SE) is a medical emergency, as deleterious long-term effects are well known. Medically induced burst suppression is often required if first-line and second-line treatments fail. Surgical intervention can be considered in some patients after prolonged treatment failure of medically induced coma. Multiple surgical options for terminating SE have been demonstrated in the literature, with only 2 reports including hemispherectomy in adults.Case DescriptionWe present 2 cases of adults with refractory SE who failed more conservative medical/surgical treatment but responded to functional hemispherectomy. Pertinent electroencephalography and imaging findings are discussed. In addition, all previously published pediatric and adult cases are briefly reviewed.ConclusionsFunctional hemispherectomy can be considered in patients, including adults, with super-refractory SE and diffuse hemispheric onset. We report acceptable outcomes and quality of life in our 2 patients.Copyright © 2016 Elsevier Inc. All rights reserved.

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