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. 2019 Nov 5:12:100337.
doi: 10.1016/j.ebr.2019.100337. eCollection 2019.

Hemispherotomy for drug-resistant epilepsy in an Indonesian population

Muhamad Thohar Arifin  1 , Zainal Muttaqin  1 , Ryosuke Hanaya  2 , Yuriz Bakhtiar  1 , Aris Catur Bintoro  3 , Koji Iida  4 , Kaoru Kurisu  4 , Kazunori Arita  2 , Erie B P S Andar  1 , Happy Kurnia B  1 , Dody Priambada  1 , Ajid Risdianto  1 , Gunadi Kusnarto  1 , Jacob Bunyamin  1
Affiliations

Hemispherotomy for drug-resistant epilepsy in an Indonesian population

Muhamad Thohar Arifin et al. Epilepsy Behav Rep. .

Abstract

Hemispherotomy is a surgical treatment indicated in patients with drug-resistant epilepsy due to unilateral hemispheric pathology. Hemispherotomy is less invasive compared with hemispherectomy. We reviewed our experience performing 24 hemispherotomy and report the results of 16 patients with prolonged follow-up of this relatively uncommon procedure in two centers in Indonesia. This is a retrospective observational study conducted from 1999 to July 2019 in two epilepsy neurosurgical centers in Semarang, Indonesia. Surgical techniques included vertical parasagittal hemispherotomy (VPH), peri-insular hemispherotomy (PIH), and modified PIH called the Shimizu approach (SA). The postoperative assessment was carried out using the Engel classification system of seizure outcome. Seizure freedom (Engel class I) outcome was achieved in 10 patients (62.5%), class II in 3 patients (18.7%), class III in 2 patients (12.5%), and class IV in 1 patient (6.3%) with follow-up duration spanning from 24 to 160 months. To the best of our knowledge, this series is the most extensive documentation of hemispherotomy in an Indonesian population.

Keywords: Drug-resistant; Epilepsy; Hemispherotomy.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Preoperative (left) and postoperative (right) axial and coronal MRI slices of a 14-year-old female (Pt. no. 10) with right-sided infantile hemiparesis showed large porencephaly cysts in her left hemisphere. Left-sided hemispherotomy was performed (PIH). Postoperative observation resulted in complete seizure freedom (Engel class I) at 98 months.
See this image and copyright information in PMC

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