John Libbey Eurotext

An algorithmic approach to preoperative studies and patient selection for hemispheric disconnection surgery: a literature review Volume 22, numéro 5, October 2020


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1 New Jersey Neuroscience Institute (NJNI), Morristown, NJ, USA
2 Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
3 Rutgers New Jersey Medical School, Newark, NJ, USA
4 Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
5 Northeast Regional Epilepsy Group, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
* Correspondence: Luke D. Tomycz New Jersey Neuroscience Institute (NJNI), Morristown, NJ, USA


Hemispheric disconnection surgery (HDS) is one of the most effective surgical options for appropriate candidates with medically-refractory epilepsy (MRE) in whom most or all seizures arise from diffuse areas within a single hemisphere. While there are several well-accepted indications for HDS, there are additional patients who may benefit from HDS. However, there are no standardized recommendations for how preoperative studies should be used to identify appropriate candidates for HDS. We aimed to propose an algorithmic approach for presurgical evaluation in order to guide appropriate implementation of HDS for either cure or palliation of severe MRE in infants, children, and adults.