Functional hemispherectomy in children with epilepsy and CSWS due to unilateral early brain injury including thalamus: Sudden recovery of CSWS

D. Battaglia, P. Veggiotti, D. Lettori, G. Tamburrini, T. Tartaglione, A. Graziano, C. Veredice, A. Sacco, D. Chieffo, A. Pecoraro, C. Colosimo, C. Di Rocco, Ch Dravet, F. Guzzetta

Research output: Contribution to journalArticle

Abstract

Purpose: To try to prove in patients with refractory symptomatic epilepsy due to early brain injury involving thalamus and complicated by CSWS the effects of the isolation of the injured hemisphere, performed with functional hemisperectomy, on epilepsy, namely on CSWS. Methods: Full clinical follow-up before and after surgery of two cases with CSWS onset at four years in whom functional hemispherecomy was performed with resection of inter-hemispheric connections. Results: An immediate effectiveness of the surgical treatment was observed on both epileptic evolution (no more seizures) and EEG abnormalities. In particular, CSWS completely disappeared, together with a concurrent progressive improving of the cognitive and behavioural disorders. Discussion: The isolation of the injured hemisphere through the section of inter-hemispheric cortico-cortical connections could prevent the contralateral diffusion of discharges coming from the injured cortex and cortico-thalamic network, favouring a normal function of thalamo-cortico-thalamic circuitries in the healthy hemisphere. That could explain the disappearance of CSWS after surgery in our patients and the consequent improvement of cognitive abilities and behaviour.

Original languageEnglish
Pages (from-to)290-298
Number of pages9
JournalEpilepsy Research
Volume87
Issue number2-3
DOIs
Publication statusPublished - Dec 2009

Keywords

  • CSWS
  • Hemispherectomy
  • Thalamic lesions

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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    Battaglia, D., Veggiotti, P., Lettori, D., Tamburrini, G., Tartaglione, T., Graziano, A., Veredice, C., Sacco, A., Chieffo, D., Pecoraro, A., Colosimo, C., Di Rocco, C., Dravet, C., & Guzzetta, F. (2009). Functional hemispherectomy in children with epilepsy and CSWS due to unilateral early brain injury including thalamus: Sudden recovery of CSWS. Epilepsy Research, 87(2-3), 290-298. https://doi.org/10.1016/j.eplepsyres.2009.09.014