ABSTRACT
AIM: Presentation of two cases of children with Rasmussen's encephalitis, treated by functional hemispherectomy. Two boys aged 4 and 6, with a typical clinical course, typical findings in CT and MRI scans and characteristic pathologic changes in brain specimens. In both cases was performed functional hemispherectomy. RESULTS: Immediate cessation of seizures in the immediate postoperative period (Engel class I and II). Later, in a 4-months' follow-up period, a worthwhile improvement in psychomotor development and social functioning was noted. Up-to date opinions published in available literature, related to pathogenesis and treatment modalities of Rasmussen's encephalitis are presented. CONCLUSIONS: 1) Rasmussen's encephalitis is a definite nosologic entity, leading to drug-resistant epilepsy and a progressive psychomotor deterioration; 2) functional hemispherectomy is a viable alternative, which should be considered in the treatment of Rasmussen's encephalitis; 3) Functional; hemispherectomy, in spite of it's aggressiveness, is a relatively safe procedure; 4) in the follow-up time of 4 months, the results are promising.
Subject(s)
Encephalitis/surgery , Neurosurgical Procedures , Seizures/prevention & control , Child , Child, Preschool , Encephalitis/complications , Encephalitis/diagnosis , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Seizures/etiology , Temporal Lobe/diagnostic imaging , Temporal Lobe/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
UNLABELLED: The aim of this paper was to assess the preliminary results of callosotomy in children with "catastrophic" drug-resistant epilepsy. During the last 5 years, we performed callosotomy in 8 cases. Indications were: "catastrophic" drug-resistant epilepsy with frequent seizures, progressive psychomotor and intellectual deterioration, generalised structural and functional abnormalities in neuroimaging and neurophysiological studies. These children were of the mean age of 6 years, with the mean duration of illness 58 months. In the mean follow-up time of 27 months the following results were obtained: Engel class II--3 cases; class III--4 cases and class IV--1 case. Any intellectual improvement was noted in 2 cases only. CONCLUSIONS: (1) callosotomy effectively reduces the frequency and severity of seizures in children with drug-resistant epilepsy; (2) in spite of reduced seizures, in the majority of cases no significant psychomotor and/or intellectual improvement was achieved; (3) callosotomy did not produce any permanent morbidity.
Subject(s)
Anticonvulsants/therapeutic use , Corpus Callosum/surgery , Epilepsy/drug therapy , Epilepsy/surgery , Adolescent , Child , Child, Preschool , Cognition Disorders/etiology , Disease Progression , Drug Resistance , Epilepsy/complications , Female , Follow-Up Studies , Humans , Infant , Male , Psychomotor Disorders/etiology , Severity of Illness Index , Treatment OutcomeABSTRACT
Encephalocraniocutaneous lipomatosis (ECCL) is a congenital neurocutaneous disorder of the adipose tissue. The dominant features of the syndrome, include: unilateral cerebral malformation, ipsilateral scalp, face and eye lesions and convulsions beginning in infancy. The authors report a case of 13-year old girl with signs of ECCL syndrome treated surgically for to intractable epilepsy.
Subject(s)
Brain Neoplasms/diagnostic imaging , Head and Neck Neoplasms/diagnostic imaging , Lipomatosis, Multiple Symmetrical/diagnostic imaging , Adolescent , Brain Neoplasms/surgery , Female , Head and Neck Neoplasms/surgery , Humans , Intelligence Tests , Lipomatosis, Multiple Symmetrical/surgery , Seizures , Syndrome , Tomography, X-Ray ComputedABSTRACT
Fourty children were treated for brain abscess in the period 1983-1988 at the Neurosurgery Department, Children's Health Centre, Warsaw. Their age was from 4 weeks to 16 years. In 38 cases the treatment was surgical, followed by antibiotic therapy, in 2 cases only antibiotics were given. In 7 cases shunts were implanted for treatment of hydrocephalus developed in infants. Two patients died during the treatment. Problems encountered in various methods of brain abscess treatment are discussed.
Subject(s)
Abscess/physiopathology , Brain Diseases/physiopathology , Brain/physiopathology , Abscess/complications , Abscess/microbiology , Adolescent , Brain Diseases/complications , Child , Child, Preschool , Female , Humans , Hydrocephalus/etiology , Hydrocephalus/physiopathology , Hydrocephalus/surgery , Infant , Infant, Newborn , Male , Neisseria/isolation & purification , Salmonella/isolation & purification , Staphylococcus/isolation & purificationABSTRACT
Aneurysms of the vein of Galen are very rare vascular anomalies found mainly in newborns and infants. In the years 1982-1989 five children with these aneurysms were treated. Their age was from 6 weeks to 16 months, all were males. The diagnosis was based on computed tomography (initial examination) and cerebral angiography. Two cases with hydrocephalus were treated with valves. The main procedure was clipping of supplying vessels. One child died during diagnostic procedures. The results in four operated on patients are good.
