Jun 18 2011
Sometimes the seizure activity, while lateralized to one side of the brain, is not sufficiently localized for removal of only a small focal area. More extensive surgery may be both necessary and helpful. Sometimes we have to take out extensive amounts of the brain or even one half of the brain, hemispherectomy.
Yes, it is possible to remove one half of the brain and still have a child of normal intelligence whose only disabilities are difficulty using the arm on the opposite side and a hemianopsia, meaning that he can’t see off to that side of his body. Such children are able to go to regular schools. When older, they can hold full-time jobs and live virtually normal, independent lives. Hemispherectomy is rarely performed, only perhaps ten to twenty times a year in this country. It is mentioned here so that you will know that it does exist and that in very carefully selected situations—when the child has severe damage to only one side of the brain, and already has damage to motor function on the other side of the body, and experiences uncontrollable seizures—a heroic operation such as this can be done. It can be life-saving and allow an otherwise profoundly handicapped child to lead a far more normal life, one free of seizures.
Rarely, or so it seems, a child is born with major abnormalities on only one side of the brain or sustains damage or inflammation (Rasmussen’s syndrome to just one hemisphere of the brain. If your child’s seizures are consistently coming from one side of the brain and do not respond to medication, it may be worth discussing the possibility of hemispherectomy with your physician.
Hemispherectomy is not a procedure for everyone, not even for everyone with damage to one side of the brain. It is major surgery that should only be done in a small number of epilepsy centers with experience with the procedure. The outcome for the child depends primarily on the normality of the remaining hemisphere. Indeed, it seems from these children that no brain tissue on one side is preferable to the constant electrical interference coming from abnormal brain tissue. It appears that this constant electrical interference impairs the function of the good side. Beth is a good example.