Analysis of the efficacy of modified hemispherotomy in the treatment of children with Sturge-Weber syndrome complicated by epilepsy
Objective To explore the surgical efficacy of modified hemispherotomy in the treatment of children with Sturge-Weber syndrome(SWS)complicated by epilepsy.Methods A retrospective analysis was conducted on the clinical data of 38 children with SWS complicated by epilepsy who were treated with modified hemispherotomy at the Department of Neurosurgery,Sanbo Brain Hospital,Capital Medical University from January 2009 to December 2020.The children's surgical efficacy,including seizure outcome and improvement in cognitive function,was followed up through outpatient clinics or online platforms 2 years after surgery and analyzed.Epileptic seizure outcome was assessed based on the International League Against Epilepsy(ILAE)criteria,and cognitive function was assessed using the Kelly score.At the same time,the cognitive function scores of children before and after surgery were stratified according to the age of surgery 1 year old,＞1 to 3 years old,＞3 to 6 years old,and＞6 years old.Results A total of 38 children underwent modified hemispherotomy.There were no instances of mortality or the development of neurological deficits following surgery.At the two-year follow-up,33 of the 38 children exhibited ILAE grade 1,2 exhibited grade 3,1 exhibited grade 4,and 2 exhibited grade 5.With regard to cognitive function,the children's cognitive function scores were superior to their preoperative scores at the two-year follow-up,with a statistically significant difference observed between the two groups(1.32±0.96 vs.1.79±1.09).The paired t-test yielded a statistically significant result(t=3.17,P=0.003).Of the 38 children,16 exhibited improved cognitive function postoperatively compared with their preoperative scores,19 demonstrated no change,and 3 exhibited a decline.Postoperative cognitive function scores(0.90±0.57)and(1.20±1.01)were superior to preoperative scores(1.80±1.14)and(1.73±1.10)in children aged≤1 year and＞1-3 years following surgery.The observed differences were statistically significant(all P＜0.05),whereas the differences between the preoperative and 2-year postoperative cognitive function scores in children aged＞3-6 and＞6 years were not statistically significant(all P＞0.05).Conclusion Modified hemispherotomy can safely and effectively control seizures in medically refractory epilepsy complicated by SWS and can improve cognitive function to some extent in children.
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