A hemispherotomy is a type of brain surgery where the two hemispheres of the brain are disconnected. Children who may benefit from this procedure already have long standing weakness on one side of their body; this is due to severe damage to the opposite side of the brain. This damage in their brain usually causes very difficult to control seizures that over time increase in frequency and severity of seizure activity. To control the seizures, disconnecting the two hemispheres of the brain can be completed.
Some increased weakness to the already affected side and loss of function can occur immediately after this procedure but usually almost fully recovers to their original level of function in time with rehabilitation such as physiotherapy and occupational therapy. A hemispherotomy may not lead to any other deficits such as language or comprehension as the brain usually has already reorganized functions to the other side.
This surgery is completed on well selected patients who have a severely damaged hemisphere and uncontrollable seizures. They will be worked up with many different tests for epilepsy surgery (i.e. MRI, EEG, and neuropsychological assessment) and discussed with the whole team at a seizure conference. The family will be a part of the discussion from the beginning and have consultations with both their epileptologist and neurosurgeon. A plan will be put in place for surgery which takes around 6-8 hours under a general anaesthetic. The patient will recover in the Paediatric Intensive Care Unit (PCCU) and then transferred to the paediatric floor for further care. Rehabilitation will be required and set up once the child is able to start.