scholarly journals Hemispherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review

2015 ◽  
Vol 15 (1) ◽  
pp. 34-44 ◽  
Author(s):  
Christoph J. Griessenauer ◽  
Smeer Salam ◽  
Philipp Hendrix ◽  
Daxa M. Patel ◽  
R. Shane Tubbs ◽  
...  

OBJECT Evidence in support of hemispherectomy stems from a multitude of retrospective studies illustrating individual institutions' experience. A systematic review of this topic, however, is lacking in the literature. METHODS A systematic review of hemispherectomy for the treatment of refractory epilepsy available up to October 2013 was performed using the following inclusion criteria: reports of a total of 10 or more patients in the pediatric age group (≤ 20 years) undergoing hemispherectomy, seizure outcome reported after a minimum follow-up of 1 year after the initial procedure, and description of the type of hemispherectomy. Only the most recent paper from institutions that published multiple papers with overlapping study periods was included. Two reviewers independently applied the inclusion criteria and extracted all the data. RESULTS Twenty-nine studies with a total of 1161 patients met the inclusion criteria. Seizure outcome was available for 1102 patients, and the overall rate of seizure freedom at the last follow-up was 73.4%. Sixteen studies (55.2%) exclusively reported seizure outcomes of a single type of hemispherectomy. There was no statistically significant difference in seizure outcome and type of hemispherectomy (p = 0.737). Underlying etiology was reported for 85.4% of patients with documented seizure outcome, and the overall distribution of acquired, developmental, and progressive etiologies was 30.5%, 40.7%, and 28.8%, respectively. Acquired and progressive etiologies were associated with significantly higher seizure-free rates than developmental etiologies (p < 0.001). Twenty of the 29 studies (69%) reported complications. The overall rate of hydrocephalus requiring CSF diversion was 14%. Mortality within 30 days was 2.2% and was not statistically different between types of hemispherectomy (p = 0.787). CONCLUSIONS Hemispherectomy is highly effective for treating refractory epilepsy in the pediatric age group, particularly for acquired and progressive etiologies. While the type of hemispherectomy does not have any influence on seizure outcome, hemispherotomy procedures are associated with a more favorable complication profile.

2007 ◽  
Vol 116 (7) ◽  
pp. 550-553 ◽  
Author(s):  
A. Sami Berçin ◽  
Ahmet Ural ◽  
Ahmet Kutluhan ◽  
Veysel Yurttaş

Objectives: We sought to examine the relationship between adenoid volume and the stage of rhinosinusitis, as well as the relationship between age and adenoid size. Methods: Forty-two children complaining of nasal discharge, whose paranasal sinus computed tomographic scans had been obtained, were involved in the study. The patients with adenoid enlargement underwent adenoidectomy. The volumes of adenoid vegetation were measured in square centimeters, and paranasal sinus computed tomographic scans were classified according to the Lund-Mackay staging system. Results: No statistically significant difference existed between patients whose Lund-Mackay scores were 0 and those with scores greater than 0. There seems to be no correlation between the Lund-Mackay score and the degree of adenoid vegetation. Conclusions: Adenoid vegetation may cause nasal discharge that is not necessarily due to sinusitis. We could not find any supportive data for the statement “The greater the adenoid tissue, the more extensive the sinusitis.”


2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Dora H. AlHarkan ◽  
Eman S. Kahtani ◽  
Priscilla W. Gikandi ◽  
Ahmed M. Abu El-Asrar

Purpose.To identify and study causes of vitreous hemorrhage (VH) in pediatric age group and to investigate factors predicting visual and anatomical outcomes.Procedure.A retrospective review of patients aged 16 years or less with the diagnosis of vitreous hemorrhage from January 2005 until December 2010.Results.A total number of 230 patients (240 eyes) were identified. Traumatic vitreous hemorrhage accounted for 82.5%. In cases of accidental trauma, final visual acuity of 20/200 was significantly associated with visual acuity of ≥20/200 at presentation and the absence of retinal detachment at last follow-up. Patients with nontraumatic vitreous hemorrhage were significantly younger with higher rates of enucleation/evisceration/exenteration and retinal detachment at last follow-up compared to traumatic cases.Conclusion.Trauma is the most common cause of VH in pediatric age group. In this group, initial visual acuity was the most important predictor for visual outcome, and the presence of retinal detachment is a negative predictor for final good visual outcome. The outcome is significantly worse in nontraumatic cases compared to traumatic cases.


2020 ◽  
Vol 7 (6) ◽  
pp. 1218
Author(s):  
Natasha L. Vageriya ◽  
Shivaji B. Mane ◽  
Taha Daginawala ◽  
Himangi Athawhale ◽  
Hussain Kotawala ◽  
...  

Background: Objective of this study is to explore various ureteric substitutes in pediatric age group and their outcomes.Methods: Retrospective analysis was done from 2003-2016, of all patients operated in this hospital that had undergone ureteral replacement. Thirteen such patients (5 from initially published paper (1) and 8 new patients) were followed up to find conduit patency, renal function and related complications with their outcomes assessed.Results: Ureteric substitution was done in 8 patients. Age of the patient ranged from 4 months to 8 years. Out of these for 2 patients monti tube was created; one with colon and other jejunum, rest of the 6 patient appendix was used. On follow up one patient had early appendico-ureteral leak requiring re-anastomosis and one patient had partial obstruction at 6 months corrected by dividing mesentry and untwisting appendix. With a mean follow up of 3.8 years all patients have preserved renal functions and drainage present. Also 5 patients of ureteral substitution performed at this institution and published prior were followed up with mean follow up of 10.4 years having no complaints with preserved function and unobstructed drainage.Conclusions: This small series supports that not only appendix and ileum but even colon as well as jejunum should be considered as Monti’s tube for ureteric replacement, when confronting with short ureter in paediatric age group.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Abdalla Mohmed Alasiri ◽  
Reem Abdullah Alasbali ◽  
Meaad Ali Alaqil ◽  
Aishah Marei Alahmari ◽  
Nouf Dagash Alshamrani ◽  
...  

Abstract Background Pulmonary alveolar proteinosis is a rare interstitial lung disease characterized by accumulating surfactant materials in the alveoli. The autoimmune form is by far the most common in adults, while in the pediatric age group, the vast majority of cases are congenital. We report a case of an adolescent patient diagnosed with autoimmune pulmonary alveolar proteinosis, which is unusual in this age group. Case presentation A-15 year-old Saudi male presented to the emergency department with a history of shortness of breath and low oxygen saturation. High-resolution computed tomography of his chest showed a global crazy-paving pattern. Autoantibodies against granulocyte-macrophage colony-stimulating factor were detected in his serum. A diagnosis of the autoimmune form of pulmonary alveolar proteinosis was confirmed after excluding other possible causes. The patient improved after he underwent whole lung lavage under general anesthesia, and he was independent of oxygen therapy after 6 months of follow-up. Conclusion The autoimmune form of pulmonary alveolar proteinosis is rare in the pediatric age group and should be considered when no apparent cause of this disease was found. Whole lung lavage should be the first treatment modality offered in this setting with close follow-up and monitoring.


2017 ◽  
Vol 8 (2) ◽  
pp. 425-428 ◽  
Author(s):  
Charudutt Kalamkar ◽  
Amrita Mukherjee

Purpose: Primary corneoscleral cyst is a rare disease occurring in the pediatric age group. We report a case of corneoscleral cyst with visual diminution. Methods: We conducted a case report. Results: A 7-year-old girl presented with corneal opacity in the left eye. Examination revealed a corneoscleral cyst. The corneal part of the cyst involved visual axis. Surgical excision with a scleral graft was performed, leading to an improvement in visual acuity. No recurrences were observed until the last follow-up at 18 months. Conclusions: Corneoscleral cyst should be considered in the differential diagnosis of cystic ocular surface disorders in the pediatric age group.


1988 ◽  
Vol 102 (6) ◽  
pp. 546-548 ◽  
Author(s):  
Mufid H. Abdu ◽  
Joseph G. Feghali

Abstract Uvulopalotopharyngoplasty (UPPP) has been recently popularized for the treatment of snoring and sleep apnea syndrome (SAS). All reported cases so far have been adults and the use of this procedure in the pediatric age group has not as yet been reported. Obstructive sleep apnea in children has been classically treated previously either medically or by adeno-tonsillectomy. The case of a three year old child with obstructive sleep apnea secondary to a large uvula and a redundant soft palate is reported. The child was successfully treated by UPPP, and remained free of symptoms for a follow-up period of one year.


2018 ◽  
Vol 15 (01) ◽  
pp. 041-042
Author(s):  
Vivek Agrawal ◽  
Pramod Giri

AbstractThe authors report a rare case of dual chronic ossified epidural hematomas (EDHs) in a 35-year-old man with complaint of seizures after 23 years of head injury. Ossified EDH is a rare entity, and it commonly presents in pediatric age group. Presenting symptoms include headache and very rarely seizures. Asymptomatic cases may produce symptoms after decades; hence, regular follow-up is required. Treatment includes craniotomy or conservative management.


Author(s):  
Vasu Gautam ◽  
RK Maurya ◽  
RK Tripathi ◽  
Ajay Kumar ◽  
Pinaki Ranjan Debnath ◽  
...  

At present, duration and methods of radiographic follow-up after pediatric pyeloplasty are not well defined. We prospectively studied pediatric age group patients to assess outcome for cases of pyeloplasty on the basis of ultrasonography and DTPA scan. : We assessed all cases of PUJ obstruction in age group 0-18 years, who got admitted in LLR hospital, Kanpur and underwent pyeloplasty. Patients were excluded if cause of pyeloplasty was acquired. Preoperatively patients underwent clinical evaluation with history and examination followed by radiological investigations including Renal USG & DTPA scan. All patients were followed up postoperatively at 3, 6, 9 & 12 months. In USG, renal parenchyma thickness, antero-posterior diameter of renal pelvis was assessed. In DTPA scan, differential renal function was assessed. Data of USG and DTPA scan were statistically compared. 32 patients who underwent pyeloplasty at a median age of 4.2 years were studied. Follow-up was done for 1 year. On the basis of our study, DTPA scan is better than renal USG to assess functional outcome after pyeloplasty in pediatric age group up to 6 months during follow-up. But results are comparable for follow-up during 9 & 12 months postoperatively. The results of our study show that in the first 6 months, renal USG is not as much informative as DTPA scan to assess functional outcome after pyeloplasty but after 6 months, renal USG is equally effective as DTPA scan.Our study concludes that for poor resource countries, renal USG can be used to assess functional outcome after pyeloplasty in pediatric age group for post-operative follow-up, instead of costly & scarcely available investigation like Renal DTPA scan.


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