Hemispherotomy in the surgical treatment of severe symptomatic epilepsy





drug-resistant epilepsy, functional hemispherotomy, neurocognitive disorders, Rasmussen’s encephalitis, cortical dysplasia


Purpose. To evaluate the efficacy of peri-insular functional hemispherotomy (FH) for patients with severe drug-resistant epilepsy.

Materials and Methods. Nine patients underwent peri-insular functional hemispherotomy. The patients included 1 adult (11.1 %) and 8 (88.8 %) children. Patients’ age ranged from 4 to 23 years (mean 9.9 ± 4.2 years). Epilepsy duration ranged from 1.5 to 16 years (mean 7.1 ± 3.1 years), mean seizures frequency was 12.9 ± 6.8 per day; before treatment patients used on average 5.1 ± 2.6 antiepileptic drugs. Diffuse injury of one hemisphere and contralateral hemiparesis were observed in all cases. Follow-up lasted from 1 to 17 months (mean 9.6 ± 1.4 months). Three (33.3 %) patients experienced Rasmussen’s encephalitis, 2 (22.2 %) had multi-lobar cortical malformation, 2 (22.2 %) had complications associated with intracerebral hemorrhage, 1 (11.1 %) patient represented with hypoxic-ischemic encephalopathy and 1 (11.1 %) patient experienced epilepsy associated with PNET resection, chemotherapy and local radiation.

Results. After FH, 7 (77.7 %) children became seizure-free (Engel Class I A), seizure recurrence was observed in one (11.1 %) case in 6 months after surgery. Perioperative complications with following death occurred in one case (11.1 %). Hydrocephalus, which required shunting developed in one (11.1 %) child.

Conclusion. Functional peri-insular hemispherotomy is an effective and safe method for surgical treatment of severe symptomatic epilepsy. Seizure cessation improves psychomotor development and diminishes neurocognitive disorders.

Author Biographies

Kostyantyn R. Kostiuk, Romodanov Neurosurgery Institute, Kyiv

Department of Functional Neurosurgery and Neuromodulation, 

Valeriy V. Cheburakhin, Romodanov Neurosurgery Institute, Kyiv

Department of Functional Neurosurgery and Neuromodulation, 

Viacheslav M. Buniakin, Romodanov Neurosurgery Institute, Kyiv

Department of Functional Neurosurgery and Neuromodulation, 


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How to Cite

Kostiuk, K. R., Cheburakhin, V. V., & Buniakin, V. M. (2019). Hemispherotomy in the surgical treatment of severe symptomatic epilepsy. Ukrainian Neurosurgical Journal, 25(3), 35–42. https://doi.org/10.25305/unj.168655



Original articles