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Journal of Child Neurology
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Bilateral Decreased Oxygenation During Focal Status Epilepticus in a Neonate With Hemimegalencephaly

Istrael Alfonso

Division of Neonatal Neurology Department of Neurology Miami, Florida

Elza Vasconcellos

Division of Neonatal Neurology Department of Neurology Miami, Florida

Hans H. Shuhaiber

Division of Neonatal Neurology Department of Neurology Miami, Florida

Ilker Yaylali

Division of Neurophysiology Department of Neurology Miami Children's Hospital Miami, Florida

Oscar Papazian

Division of Neurophysiology Department of Neurology Miami Children's Hospital Miami, Florida

Early surgical removal of a dysplastic hemisphere appears to be beneficial for neonates with hemimegalencephaly and medically resistant seizures. We analyzed the changes in the cerebral regional oxygen saturation index in a neonate with tuberous sclerosis and right hemimegalencephaly (1) during seven episodes of right hemisphere electroencephalographic status epilepticus with and without clinical manifestations and (2) after right hemispherectomy. The cerebral regional oxygen saturation index demonstrated marked fluctuations and progressive decline in both hemispheres during the episodes and normal values in the remaining hemisphere after surgery. We speculate that decreased oxygenation of the nonepileptic cerebral hemisphere in patients with hemimegalencephaly and medically resistant seizures can contribute to the production of global neurologic impairments in these patients and that the benefits of early hemispherectomy are due to the improved oxygenation of the nondysplastic hemisphere following surgery. (J Child Neurol 2004; 19:394-396).

Journal of Child Neurology, Vol. 19, No. 5, 394-396 (2004)
DOI: 10.1177/088307380401900516
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