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Brain Surgery Shows Benefit in Pediatric Stroke Patients

Children with refractory seizures showed improvements after periinsular hemispherotomy

MONDAY, Feb. 23 (HealthDay News) -- Periinsular hemispherotomy may be useful in treating stroke-induced refractory epilepsy in children, according to research published in the February issue of the Journal of Neurosurgery: Pediatrics.

Didier Scavarda, M.D., of the Hopital des Enfants La Timone in Marseille, France, and colleagues reviewed the cases of eight children with stroke-induced refractory epilepsy who underwent periinsular hemispherotomy. The mean age at stroke was 23 months, median age of onset of refractory seizures was 53 months, and mean interval between diagnosis of refractory epilepsy and surgery was 40 months.

Over the long term, none showed neuropsychological improvement, but caregivers reported improvement in alertness and global functioning, the report indicates. None seemed to have a worse outcome compared to their preoperative motor function. Seven remain seizure-free; all are still using antiepileptic drugs, but are taking fewer of them, the researchers report.

The delay between seizure onset and surgery and the lengthy period of refractory seizures may explain the lack of intellectual improvement seen in the children, the authors suggest. "To improve outcome we believe that it is important to reduce the duration of the refractory seizures. As soon as late seizures appear in children after stroke and two proper antiepileptic drugs have failed in the child, we propose that parents, neurologists and neurosurgeons must discuss the option of a hemispherotomy," they write.

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