TY - JOUR
T1 - Functional hemispheric disconnection procedures for chronic epilepsy
T2 - history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section
AU - Schijns, Olaf E.M.G.
AU - Delev, Daniel
AU - von Lehe, Marec
AU - van Roost, Dirk
AU - Rössler, Karl
AU - Theys, Tom
AU - Auer, Christian
AU - Blauwblomme, Thomas
AU - Budke, Marcelo
AU - Campos, Alexandre Rainha
AU - Canto, Santiago Candela
AU - Clusmann, Hans
AU - Dorfer, Christian
AU - Dorfmüller, Georg
AU - Egge, Arild
AU - Eröss, Lorand
AU - Ferrand-Sorbets, Sarah
AU - Giordano, Flavio
AU - Honegger, Jürgen
AU - Isler, Cihan
AU - Ivanovic, Jugoslav
AU - Kalbhenn, Thilo
AU - Karppinen, Atte
AU - Krayenbühl, Niklaus
AU - van Lanen, Rick H.G.J.
AU - Marras, Carlo E.
AU - Mavridis, Ioannis
AU - Nilsson, Daniel
AU - Onken, Julia
AU - Raftopoulos, Christian
AU - Roth, Jonathan
AU - Rumia, Jordi
AU - Sauvigny, Thomas
AU - Scavarda, Didier
AU - Schaller, Karl
AU - Scheiwe, Christian
AU - Schuind, Sophie
AU - Seromenho-Santos, Alexandra
AU - Fountas, Kostas
N1 - Funding Information:
None.
Publisher Copyright:
© 2024 The Authors
PY - 2024/1
Y1 - 2024/1
N2 - Introduction: The surgical procedure for severe, drug-resistant, unilateral hemispheric epilepsy is challenging. Over the last decades the surgical landscape for hemispheric disconnection procedures changed from anatomical hemispherectomy to functional hemispherotomy with a reduction of complications and stable good seizure outcome. Here, a task force of European epilepsy surgeons prepared, on behalf of the EANS Section for Functional Neurosurgery, a consensus statement on different aspects of the hemispheric disconnection procedure. Research question: To determine history, indication, timing, techniques, complications and current practice in Europe for hemispheric disconnection procedures in drug-resistant epilepsy. Material and methods: Relevant literature on the topic was collected by a literature search based on the PRISMA 2020 guidelines. Results: A comprehensive overview on the historical development of hemispheric disconnection procedures for epilepsy is presented, while discussing indications, timing, surgical techniques and complications. Current practice for this procedure in European epilepsy surgery centers is provided. At present, our knowledge of long-term seizure outcomes primarily stems from open surgical disconnection procedures. Although minimal invasive surgical techniques in epilepsy are rapidly developing and reported in case reports or small case series, long-term seizure outcome remain uncertain and needs to be reported. Discussion and conclusion: This is the first paper presenting a European consensus statement regarding history, indications, techniques and complications of hemispheric disconnection procedures for different causes of chronic, drug-resistant epilepsy. Furthermore, it serves as the pioneering document to report a comprehensive overview of the current surgical practices regarding this type of surgery employed in renowned epilepsy surgery centers across Europe.
AB - Introduction: The surgical procedure for severe, drug-resistant, unilateral hemispheric epilepsy is challenging. Over the last decades the surgical landscape for hemispheric disconnection procedures changed from anatomical hemispherectomy to functional hemispherotomy with a reduction of complications and stable good seizure outcome. Here, a task force of European epilepsy surgeons prepared, on behalf of the EANS Section for Functional Neurosurgery, a consensus statement on different aspects of the hemispheric disconnection procedure. Research question: To determine history, indication, timing, techniques, complications and current practice in Europe for hemispheric disconnection procedures in drug-resistant epilepsy. Material and methods: Relevant literature on the topic was collected by a literature search based on the PRISMA 2020 guidelines. Results: A comprehensive overview on the historical development of hemispheric disconnection procedures for epilepsy is presented, while discussing indications, timing, surgical techniques and complications. Current practice for this procedure in European epilepsy surgery centers is provided. At present, our knowledge of long-term seizure outcomes primarily stems from open surgical disconnection procedures. Although minimal invasive surgical techniques in epilepsy are rapidly developing and reported in case reports or small case series, long-term seizure outcome remain uncertain and needs to be reported. Discussion and conclusion: This is the first paper presenting a European consensus statement regarding history, indications, techniques and complications of hemispheric disconnection procedures for different causes of chronic, drug-resistant epilepsy. Furthermore, it serves as the pioneering document to report a comprehensive overview of the current surgical practices regarding this type of surgery employed in renowned epilepsy surgery centers across Europe.
KW - Complications
KW - Epilepsy surgery
KW - Functional hemispherotomy
KW - Hemispheric disconnection
KW - Indications
KW - Techniques
U2 - 10.1016/j.bas.2024.102754
DO - 10.1016/j.bas.2024.102754
M3 - Article
SN - 2772-5294
VL - 4
JO - Brain and Spine
JF - Brain and Spine
M1 - 102754
ER -