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Journal of Child Neurology
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Hemispherectomy in Early Infantile Epileptic Encephalopathy

Lorie Hamiwka, MD

Neuroscience Program and Department of Neurology, Miami Children's Hospital, Miami, Florida

Michael Duchowny, MD

Neuroscience Program and Department of Neurology, Miami Children's Hospital, Miami, Florida, michael.duchowny{at}mch.com, Department of Neurology, University of Miami School of Medicine, Miami, Florida

Israel Alfonso, MD

Neuroscience Program and Department of Neurology, Miami Children's Hospital, Miami, Florida

Edward Liu, MD

Neuroscience Program and Department of Neurology, Miami Children's Hospital, Miami, Florida

The authors report the successful surgical treatment of early infantile epileptic encephalopathy and suppression burst in 2 children with hemispheric dysplasia. At surgical evaluation, focal epileptic patterns were recorded from the abnormal hemisphere, and ictal single-photon emission computed tomography demonstrated ipsilateral regional hyperperfusion. Functional hemispherectomy was performed after electrocorticography revealed near-continuous spike and slow-wave discharges over the affected hemisphere. Histopathology revealed Taylor-type cortical dysplasia. Postoperatively, both patients are seizure free on antiepileptic drug monotherapy and have shown improved developmental status. Their favorable outcome demonstrates that children with early infantile epileptic encephalopathy due to unilateral malformations of cortical development may benefit from early surgical intervention.

Key Words: early infantile epileptic encephalopathy • Ohtahara syndrome • childhood epilepsy • hemispherectomy • epilepsy surgery

Journal of Child Neurology, Vol. 22, No. 1, 41-44 (2007)
DOI: 10.1177/0883073807299974
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