Disconnective Surgery for Refractory Multilobar and Hemispheric Epilepsy, A Study of 38 Children

Abstract

Intractable epilepsy secondary to multilobar and hemispheric 
pathologies is more prevalent in young children [1]. The 
negative impact of such seizures on neurological, intellectual 
and psychosocial development, as well as the risk of irreversible 
consequences in later life, has been well documented [2-4]. 
There is also a higher risk of mortality in these patients, often 
from status epilepticus and sudden unexpected death [5]. As a 
significant proportion of multilobar and hemispheric epilepsies 
are due to developmental malformations and in-utero insults, 
seizures often manifest very early in life. The vulnerability of the 
developing brain can lead to an increased frequency and severity 
of seizures, especially epileptic spasms and status epilepticus. 
The immaturity of the brain also increases risk of seizures being 
resistant to anticonvulsant medications [6].