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NEUROLOGY 1991;41:1790
© 1991 American Academy of Neurology

Functional hemispherectomy

EEG findings, spiking from isolated brain postoperatively, and prediction of outcome

Shelagh J.M. Smith, MD, Frederick Andermann, MD, FRCP(C), Jean-Guy Villemure, MD, FRCS(C), Theodore B. Rasmussen, MD and Luis Felipe Quesney, MD, PhD

Department of Neurology and Neurosurgery, McGill University, and the Montreal Neurological Hospital and Institute, Montreal, PQ, Canada.

We reviewed the prognostic significance of preoperative EEG findings in 25 patients who underwent functional hemispherectomy. Bilateral independent epileptogenic foci, found in five patients, generally indicate a less satisfactory outcome, with only three of the five patients becoming seizure free following hemispherectomy. In contrast, abnormalities of background activity over the "good" hemisphere, multifocal epileptic activity confined to the side of operation, or bilaterally synchronous discharges were associated with a good outcome and should not be considered as contraindications to operation. Postoperatively, discharges may occur in the functionally isolated frontal and occipital cortex, which are benign, with no other clinical significance than showing that the isolated cortex remains viable and continues to generate epileptogenic potentials.

Address correspondence and reprint requests to Dr. Frederick Andermann, Montreal Neurological Hospital and Institute, 3801 University Street, Montreal, PQ, Canada H3A 2B4.

Received January 15, 1991. Accepted for publication in final form April 19, 1991.




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