Functional hemispheric disconnection procedures for chronic epilepsy: history, indications, techniques, complications and current practice in Europe. A consensus statement on behalf of the EANS functional neurosurgery section.
Journal: Brain & spine
Volume: 4
Issue:
Year of Publication:
Affiliated Institutions:
Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands.
Department of Neurosurgery, RWTH Aachen University Hospital, Aachen, Germany.
Department of Neurosurgery, Ruppiner Kliniken, Neuruppin, Germany.
Department of Neurosurgery, University Hospital Ghent, Ghent, Belgium.
Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Department of Neurosurgery, University Hospital Leuven, Leuven, Belgium.
Department of Neurosurgery, Johannes Kepler University Linz, Kepler University Hospital, Linz, Austria.
Department of Pediatric Neurosurgery, Hôpital Necker, Université de Paris, Paris, France.
Department of Neurosurgery, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
Department of Neurosurgery, Hospital Santa Maria, Lisbon, Portugal.
Department of Neurosurgery, Hospital Sant Joan de Deu, Barcelona, Spain.
Department of Neurosurgery, Hopital Fondation Adolphe de Rothschild, Paris, France.
Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
Department of Neurosurgery, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.
Department of Neurosurgery, Meyer Children's Hospital IRCCS, University of Florence, Italy.
Department of Neurosurgery, University Hospital, Tübingen, Germany.
Department of Neurosurgery, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Department of Neurosurgery, Bielefeld University, Medical School, Bielefeld, Germany.
Department of Neurosurgery, University of Helsinki, Helsinki University hospital, Helsinki, Finland.
Department of Neurosurgery, Universitäts-Kinderspital Zürich-Eleonorenstiftung, Zürich, Switzerland.
Department of Neurosurgery, Ospedale Pediatrico Bambino Gesu, Roma, Italy.
Department of Neurosurgery, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
Department of Neurosurgery, Sahlgrenska University hospital, Göteborg, Sweden.
Department of Neurosurgery, Charite University hospital, Berlin, Germany.
Department of Neurosurgery, Clinique Universitaires Saint Luc, Brussels, Belgium.
Department of Neurosurgery, Tel Aviv Sourasky medical center, Tel Aviv, Israel.
Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Neurosurgery, Hopital La Timone Enfants, Marseille, France.
Department of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland.
Department of Neurosurgery, University hospital, Freiburg, Germany.
Department of Neurosurgery, Hopital Erasme, Brussels, Belgium.
Department of Neurosurgery, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
Department of Neurosurgery, University of Thessaly Medical School, Larissa, Greece.
Abstract summary
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.To determine history, indication, timing, techniques, complications and current practice in Europe for hemispheric disconnection procedures in drug-resistant epilepsy.Relevant literature on the topic was collected by a literature search based on the PRISMA 2020 guidelines.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.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.
Authors & Co-authors:
Schijns
Delev
von Lehe
van Roost
Rössler
Theys
Auer
Blauwblomme
Budke
Campos
Canto
Clusmann
Dorfer
Dorfmüller
Egge
Eröss
Ferrand-Sorbets
Giordano
Honegger
Isler
Ivanovic
Kalbhenn
Karppinen
Krayenbühl
van Lanen
Marras
Mavridis
Nilsson
Onken
Raftopoulos
Roth
Rumia
Sauvigny
Scavarda
Schaller
Scheiwe
Schuind
Seromenho-Santos
Fountas
Study Outcome
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