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49th Annual Meeting of the AANS/CNS Section on Ped ...
Hemispherectomy in Children with Epilepsy: A 10 Ye ...
Hemispherectomy in Children with Epilepsy: A 10 Year Review - Wen Sha
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Video Transcription
Hello everyone, my name is Wensha. Today, I will be presenting about our work of HEMIS4-Actomic in children with epilepsy, a 15 year review. HEMIS4-Actomic refers to a surgical produce which complete removal or functional disconnection of a cerebral HEMIS4 for epilepsy patients. A peritoneal HEMIS4-Actomic is a functional HEMIS4-Actomic technique with minimal brain tissues removal. All patients in this cohort underwent a PIH. We performed a chart review and analysis 60 patients who underwent a HEMIS4-Actomic between 2004 and 2019. These outcomes were averaged from baseline to one, two, three, and five years post-surgery. We separate the population into angle class one and no angle class one. Our cohort had a majority male patients and a majority of Caucasian race. Preoperatively, 78% of our patient has seizure delay frequency, while 33% of the patient underwent a pro-epilepsy surgery. When analyzing our cohort, the median age of seizure onset is 13 months of age and the median age of their first HEMIS4-Actomic surgery is 71 months. The median time between the first seizure onsite and the first HEMIS4-Actomic surgery was 36 months. We have eight patients who had a complication. Of note, only one stroke was clinically significant. At six months after surgery, 70% of the patients had seizure-free outcome. Three patients needed a second epilepsy-based surgery following their intentional HEMIS4-Actomic. One patient required a conversion from a functional HEMIS4-Actomic to economical. The other two patients include a lysine ablation and a frontal lobe resection. We use logistic regression model to identify preoperative variables associated with seizure freedom. As we can see, the last three variables P-value are less than 0.05, which means they have association with seizure freedom. Using a distribution of our patient size, we separate our cohort into three groups by age. Our analysis shows that young age group has greater seizure freedom than the other groups. We have 55 patients follow up after one year and 76% of them had seizure-free outcome. We have 42 patients follow up after two years and 81% of them had seizure-free outcome. Next, we have 38 patients follow up after three years and 79% of them had seizure-free outcome. We have 27 patients follow up after five years and 89% of them had seizure-free outcome. To summarize, HEMIS4-Actomic is a reliable and effective technique. It has a high percentage of Angle Cas1 and has a limited complication rate. There is association between seizure freedom and age of seizure onset, age of first HEMIS4-Actomic surgery and time between first seizure onset and the first HEMIS4-Actomic surgery. Data also suggest that early intervention leads to even greater reduction of seizures. That's all we have. I'd also like to thank my mentors, Dr. Blanc and Dr. Rizzo. Thank you for listening to our presentation.
Video Summary
The video presentation is about the work of HEMIS4-Actomic in children with epilepsy, specifically a 15-year review. HEMIS4-Actomic is a surgical procedure that involves the complete removal or functional disconnection of a cerebral HEMIS4 for epilepsy patients. The study analyzed the outcomes of 60 patients who underwent the procedure between 2004 and 2019. The majority of patients were male and Caucasian. Preoperatively, most patients experienced a delay in seizure frequency, and some had undergone previous epilepsy surgeries. The median age of seizure onset was 13 months, and the median age of the first HEMIS4-Actomic surgery was 71 months. Only one stroke complication was clinically significant. Six months post-surgery, 70% of patients were seizure-free. Three patients required a second surgery, including a conversion to an economical procedure and other types of ablation and resection. Logistic regression analysis showed that certain preoperative variables were associated with seizure freedom. The study concluded that HEMIS4-Actomic is a reliable and effective technique, with higher success rates in younger patients, suggesting that early intervention leads to better seizure reduction. The mentors mentioned are Dr. Blanc and Dr. Rizzo.
Keywords
HEMIS4-Actomic
children with epilepsy
surgical procedure
seizure frequency
epilepsy surgeries
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