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01-05-2020 | Cerebral Sinus Venous Thrombosis | Original Article

Transient water-electrolyte disturbance after hemispherotomy in young infants with epileptic encephalopathy

Authors: Takashi Saito, Kenji Sugai, Akio Takahashi, Naoki Ikegaya, Eiji Nakagawa, Masayuki Sasaki, Masaki Iwasaki, Taisuke Otsuki

Published in: Child's Nervous System | Issue 5/2020

Abstract

Purpose

This study aimed to elucidate the clinical features of water-electrolyte disturbance (WED) as a sequela of hemispherotomy.

Methods

We performed a retrospective chart review to identify the clinical features of diabetes insipidus (DI) as a complication in < 12-month-old patients who underwent hemispherectomy or hemispherotomy for severe epilepsy between 2007 and 2018. Central DI was diagnosed if a patient developed polyuria (urine output > 5 mL/kg/h), abnormally high serum osmolality (> 300 mOsm/kg), high serum sodium level (> 150 mEq/L), either abnormally low urine specific gravity (< 1.005) or low urine osmolality (< 300 mOsm/kg) or both, and effective control of polyuria with arginine vasopressin (AVP). The clinical course of post-hemispherotomy WED, complications other than WED, and seizure outcomes were analyzed.

Results

The review identified that 3 of 23 infants developed WED. All patients developed polyuria within 2 days after surgery, with high serum osmolality and hypotonic urine; AVP was effective in treating these symptoms. The clinical course was compatible with central DI. Two patients subsequently developed hyponatremia in a biphasic or triphasic manner. All patients had multiple seizures that were probably related to WED. Two patients developed asymptomatic cerebral sinovenous thrombosis, possibly because of the surgical procedure and dehydration; anticoagulant treatment was provided. All patients were treated for WED for up to 2 months and had no residual pituitary dysfunction.

Conclusion

Systemic complications other than intracranial ones can occur in patients who have undergone hemispherotomy. Perioperative systemic management of young infants undergoing this procedure should include careful water and electrolyte balance monitoring.

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Title: Transient water-electrolyte disturbance after hemispherotomy in young infants with epileptic encephalopathy
Authors: Takashi Saito
Kenji Sugai
Akio Takahashi
Naoki Ikegaya
Eiji Nakagawa
Masayuki Sasaki
Masaki Iwasaki
Taisuke Otsuki
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Cerebral Sinus Venous Thrombosis
Sturge-Weber Syndrome
Epilepsy
Hypernatremia
Hyponatremia
Encephalopathy
Published in: Child's Nervous System / Issue 5/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04452-1

ACC 2024 Congress

Springer Medicine

Transient water-electrolyte disturbance after hemispherotomy in young infants with epileptic encephalopathy

Abstract

Purpose

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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