Bruno Camporeze

HEMISPHERECTOMY: WHY WE STILL USE IN EPILEPSY TREATMENT? TECHNICAL PITFALLS, RESULTS AND COMPLICATIONS

Objective is to discuss the indications, technical details, risks, complications, results and prognosis of hemispherectomy in the treatment of seizures based on critical literature review and the authors experience. Materials and methods. It was performed bibliographical consultation from 1920 to 2016, using as keywords “seizures”, “epilepsy”, “hemispherectomy”, in the databases MEDLINE, LILACS, SciELO, PubMed, utilizing language as selection criteria, choosing preferably recent articles in Portuguese, Spanish or English and only articles based in humans studies. Results. The functional hemispherectomy showed improvent in the quality of life of patients that has the indication to perform this procedure because it allows reducing the frequency of seizures, whether tonic or atonic, tonic-clonic. Furthermore, it has been associated to a low rates of postoperative complications, like superficial hemosiderosis, ependymitis and obstructive hydrocephalus that often it has been showed in anatomical hemispherectomy. Conclusion. The functional hemispherectomy has been showed a significant impovement in the outcome for those with seizures arising when indicated to selected cases. However, we concluded that there is no important study comparing the functional hemispherectomy approaches with results adjusted for different causative pathologies, what would be for future necessary for an important source of data about this topic.