Znieczulenie dziecka z lekooporną padaczką do zabiegu hemisferektomii

*Krzysztof Kobylarz^{1, 2}, Iwona Szlachta-Jezioro², Stanisław Kwiatkowski³

Summary
Background.Epilepsy is one of the most frequent chronic diseases of the central nervous system in children. Although the epilepsy can be pharmacologically controlled in 80%, surgical intervention may be required in selected cases.
Case report. A 4-yr-old, 17 kg, mentally retarded boy with left hemiparesis was admitted to the hospital because of drug-resistant epilepsy. Hemimegaloencephalia was diagnosed and the boy was scheduled for a left cerebral hemispherectomy and excision of the epileptogenic focus located in the left parietal region. The surgery was complicated by significant bleeding and hypotension, however approximately 200 g of brain tissue was removed and the middle cerebral artery was clipped. The immediate postoperative course was complicated by significant bleeding, treated conservatively. Subsequent hygroma was removed by needle puncture. The remainder of the postoperative period was uneventful, and the boy was discharged home one week after surgery in a stable condition and free of seizures.
Conclusions. Hemispherectomy can be a valuable procedure for relieving the burden of seizures, the burden of medication, and the general dysfunction in children with severe or progressive unilateral cortical disease.

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