Intractable Epilepsia in Pediatric Populations: Surgical Approaches, Results, and Therapy, A Comprehensive Systematic Review of the Literature in Hemispherectomy
Bibliographic record
Abstract
A hemispherectomy is a surgical procedure in which the basal ganglia are retained but the entire cerebral hemisphere is removed. This technique was used by Dandy in 1928 to remove a glioma. McKenzie, a Canadian doctor, performed the first hemispherectomy on an epileptic patient in 1938. A comprehensive review of the scientific literature was carried out using the recommended guidelines. Using PRISMA (Preferred Reporting Items for Systematic Reviews) guidelines, this study carefully evaluated the scholarly literature on surgical outcomes and treatment regimens. We followed the EXCEL criteria, Rayyan (Intelligent Systematic Review), and R software. Academic publications were found in databases such as ScienceDirect and PubMed/MEDLINE Studies published in English up until January 2024. Our study of epileptic patients with intractable epilepsy involved a total of 1157 patients, of whom 708 underwent hemispherectomy. Table 1-2-3, and Figure 2,3,4, 5show the patients' demographic breakdown: 195 patients, or 27.54%, had cortical dysplasia, seizures, or Rasmussen encephalitis; 305 patients, or 43.08%, had seizures; 87 patients, or 12.29%, had strokes or Weber syndrome; 449 patients, or 72.8% of the patients, out of 325 patients, had the Engel type 1 classification; and 232 patients, or 51.67% of the patients, had Engel type 2. The results of this pediatric systematic review led us to the conclusion that, once an infant's nonexistent seizure count is reached, either through conservative or immunoregulatory therapy or brain stimulation, hemispherectomy is the most stable course of action. Intractable epilepsy is essentially treatable.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.029 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.019 | 0.017 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".