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Seizure outcome after functional hemispherectomy for malformations of cortical development

From the Departments of Neurology (Drs. Carreño, Wyllie, and Kotagal), Neurosurgery (Drs. Bingaman and Comair), and Neuroradiology (Dr. Ruggieri), The Cleveland Clinic Foundation, OH. Dr. Comair is now at the American University Hospital in Beirut.

Address correspondence and reprint requests to Dr. Elaine Wyllie, Head, Section of Pediatric Epilepsy, The Cleveland Clinic Foundation, S-51, 9500 Euclid Avenue, Cleveland, OH 44195.

MRI features were correlated with postsurgical seizure outcome in patients with hemispheric malformations of cortical development (MCD). After functional hemispherectomy, 5 of 6 patients (83%) with hemimegalencephaly had persistent, although markedly improved, seizures; 5 of 6 patients (83%) with relative preservation of part of one lobe or atrophy were seizure free. Hemimegalencephaly and other types of hemispheric MCD appear to differ in prognosis for freedom from seizures after functional hemispherectomy.

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