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To study the effect of functional hemispherotomy on electrical status epilepticus during slow wave sleep (ESES) and language development. The source-population comprised prospectively collected data from patients with a history of at least 2 years after functional hemispherotomy. Study inclusion criteria were ascertained diagnosis of ESES prior to surgery and complete developmental follow-up data. A control group without ESES was drawn from the source population. Language Quotients (LQ) prior to surgery and at last follow-up were calculated. Hypotheses were: (1) Children with ESES have lower preoperative LQs than children without ESES; (2) Remission of ESES after surgery is associated with significant ‘catch up’ of the LQs. Nonparametric Wilcoxon and Chi-square tests were applied. 11 cases (five female) and 21 controls (eleven female) were included. Prior to surgery, children with ESES had significantly lower LQs compared with their controls ( p = 0.015). The median follow-up after surgery was 6.0 years (±2.2; range 2–9 years). ESES remitted immediately after surgery in 90.9% of the patients. A significant increase in LQ was noticed in these children ( p = 0.038). The results were independent of the side of surgery. Functional hemispherotomy may have beneficial effects on ESES and further language development. [ABSTRACT FROM AUTHOR]

Objective: Vagus nerve stimulator (VNS) implantation is an established therapy for pharmacoresistant epilepsy that is not amenable to curative epilepsy surgery. Historically, VNS implantation has been performed by neurosurgeons, but otolaryngologist involvement is increasingly common. In this retrospective study, we aimed to evaluate the efficacy and safety of VNS implantation in children and adolescents from the otolaryngologists' perspective. Methods: This study included children and adolescents who had undergone VNS implantation at the study center between 2014 and 2018. Patient files were analyzed with regards to the durations of device implantation and hospitalization, postoperative complications, and clinical outcome, including seizure frequency, clinical global impression of improvement (CGI-I) score, and quality of life (QoL). Results: A total of 73 children underwent VNS surgery. The median age at implantation was 9.3 ± 4.6 years, and median epilepsy duration before VNS surgery was 6 ± 4 years. Lennox–Gastaut syndrome was the most common syndrome diagnosis (62.3%), and structural abnormalities (49.3%) the most frequent etiology. Operation times ranged from 30 to 200 min, and median postoperative hospitalization length was 2 ± 0.9 days. No complications occurred, except for four revisions and two explantations due to local infections (2.7%). Among our patients, 76.7% were responders (≥ 50% reduction in seizure frequency), 72.1% showed improved CGI-I scores, and 18.6–60.5% exhibited considerable improvements in the QoL categories energy, emotional health, and cognitive functions. Conclusion: Our results indicate that VNS implantation is a highly effective and safe treatment option for children and adolescents with AED-refractory epilepsies who are not candidates for curative epilepsy surgery. [ABSTRACT FROM AUTHOR]