Abstracts

RATIONALE: To report the complete national series of hemispherectomies and multilobe resections in Sweden by use of the Swedish national epilepsy surgery register. METHODS: Epilepsy surgery in Sweden is performed at six surgical centres and data on all procedures are collected in a national register. This study includes 36 patients treated with a hemispherectomy or a multilobe resection September 1990 to 1995 followed two years postoperatively. The resection was defined as a multilobe resection if two or more lobes were resected. It was defined as a subtotal hemispherectomy when e.g. the visual cortex was left intact not to hazard a possibly still functioning visual field. RESULTS: A multillobe resection was performed in 20 patients, 13 patients had comlete hemispherectomies (five of which were functional) and four patients had a subtotal hemspherectomy. Following hemispherectomies 69 % were seizure free, another 23 % had > 75 % reduction of seizure frequency. Of the patients undergoing a subtotal hemispherectomy none was seizure free, but 50 % had > 75 % reduction of seizure frequency. Of the patients undergoing multilobe resections 25% were seizure free and another 10 % had > 75 % reduction of seizure frequency. The procedures had a major complication rate of 5.6 %. CONCLUSIONS: After a complete hemispherectomy 92 % of the patients became seizure free or had a > 75 % reduction of seizure frequency. This contrasts with the low frequency of seizure freedom for patients who had undergone multilobe resections or subtotal hemispherectomies. The national results in Sweden where epilepsy surgery is performed at six centres are comparable with the results reported from single major epilepsy surgery centres. In spite of being major surgical procedures in sometimes very young children the complication rate of 5.6 % is also acceptable.