Surgical strategies after failed hemispheric disconnection surgery: A systematic review and individual-patient data analysis.
SeizureJul 2, 2026 (epub)
Clinical ResearchNeurosurgery
Daniel Sescu, Abdel-Rahman Abdel Fattah, Jose Araya Quezada et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review analyzed surgical outcomes after failed hemispheric disconnection surgery in patients of all ages. The study found that redo hemispheric surgery (RHS) achieved Engel I outcomes in 50% of cases and Engel I-II in 69%. The median seizure-free survival after RHS was 4.5 years, indicating its effectiveness as a salvage strategy.
Key findings
- The pooled incidence of reoperation after failed hemispheric disconnection surgery was 18%.
- Engel I outcome was achieved in 50% of patients after redo hemispheric surgery.
- Median seizure-free survival after redo hemispheric surgery was 4.5 years.
- Engel I duration was significantly longer after redo hemispheric surgery compared to laser interstitial thermal therapy.
Why it matters
Understanding the outcomes of secondary interventions after failed hemispheric disconnection surgery is crucial for clinicians to make informed decisions and provide accurate counseling to patients regarding their treatment options and expected results.