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| | Cleveland Clinic > Neuroscience > What We Treat > Epilepsy > Epilepsy Surgery > Procedures > ... |
 | | Results from our series demonstrate hemispherectomy is a successful and safe technique to stop medically intractable epilepsy in a select group of pediatric patients. | | | Variations in the technique exist and the appropriate surgery may be dictated by the underlying pathology. | | | Despite the variation in techniques, outcomes after both surgeries are reported to be equal and may approach 60-80% seizure free. |
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http://www.clevelandclinic.org/neuroscience/treat/epilepsy/surgery/procedures/hemispherectomy.htm
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| | Hemispherectomy: a hemidecortication approach and review of 52 cases |
| | Ameli NO: Hemispherectomy for the treatment of epilepsy and behavior disturbance. | | | This technique undoubtedly results in a triangular wedge of cortex containing the venous stubs that is very similar to that described by Dandy.[14] The insular cortex was the last area of resection because in very young patients, manipulation of this area seems to be associated with some degree of cardiovascular instability. | | | We have performed ten additional hemispherectomies with good results since January 1995, and the future addition of these results to our case reviews may offer more insight into the roles of plasticity (determined by age at surgery) and accumulated injury (determined by the interval to surgery) in the outcome of hemispherectomy. |
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http://www.aans.org/education/journal/neurosurgical/preview/642696june1.html
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| | SURGICAL TREATMENT OF EPILEPSY - Neurosurgical Service - Massachusetts General Hospital |
| | Functional hemispherectomy or any of its variants, is one of the most successful surgical procedures for epilepsy with over 85% markedly improved and about 60% seizure free.(25) Many patients also demonstrate behavioral improvement probably on the basis of a better attention span and cognitive functioning. | | | The acute surgical risk is that some crude movement or sensation on the opposite side of the body would be adversely affected. | | | While resection techniques (lesionectomy, lobectomy, hemispherectomy, corticectomy) generally yield the best surgical results, disconnection (callosotomy, subpial transection) and augmentation (cerebellar and vagal stimulation) techniques remain worthwhile considerations (Table 2). |
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http://neurosurgery.mgh.harvard.edu/Functional/ep-sxtre.htm
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| | CNS Spectrums |
| | However, hemispherectomy is recommended unless there has been a significant and sustained response to medical therapies. | | | The irreversible nature of surgical therapy makes hemispherectomy a last resort therapeutic measure. | | | This procedure should especially be considered for patients with established hemiplegia and intractable and disabling epilepsy. |
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http://www.cnsspectrums.com/article.php3?id=39
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| | Hemispherectomy Ends Seizures In Many Older Children With Rare Seizure Disorder |
| | This is contrary to all other previous studies on Sturge-Weber s yndrome and hemispherectomy, which emphasized early surgery to avoid cognitive decline," said Kossoff. | | | Information was collected regarding the child's preoperative condition, details of the surgical procedure and hospital stay, and the child's current neurological status. | | | Some 80 percent of Sturge-Weber patients develop epilepsy. |
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http://www.sciencedaily.com/releases/2002/12/021211084340.htm
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| | Placing Reactions, Concluding With A Demonstration Of The Development Of Corticofugal Inhibition |
| | To the extent that forelimb placing is homologous with distal limb function in the human after cortical injury, these results offer a new approach to the active treatment of stroke with hemiplegia. | | | This experiment exposes the ontogenesis of corticofugal influences on a behavior whose essential features appear to be organized subcortically. | | | We have found that the complete loss which follows a frontal lobe removal is succeeded by gradual reacquisition of chin contact placing so that in 8 - 12 weeks the majority showed responses hardly distinguishable from that of the unaffected limb. |
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http://www.cco.caltech.edu/~jbogen/text/placing.htm
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| | Research Shows Removal Of Half A Brain Improves Epileptic's Quality Of Life |
| | Success of surgery must be measured in terms of the child's preoperative condition and the change in that condition after surgery. | | | The families also understood that surgery would result in the permanent loss of mobility in their child's hand, in exchange for relief from seizures and their treatment. | | | Of the 54 children who survived surgery, 29 are seizure-free. |
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http://www.pslgroup.com/dg/3358a.htm
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| | [No title] |
| | However, recent findings in studies of focal lesions and hemispherectomy (in humans and animals) challenge the assumption that the relationship between age and motor/cognitive recovery is monotonic ADDIN ENRef (Bates, 1999a; Bates, Vicari, & Trauner, 1999b; Eisele & Aram, 1995; Reilly, Bates, & Marchman, 1998; Vargha-Khadem, 1991; Villablanca & Hovda, 2000). | | | Second, contrary to research on focal brain lesions, hemispherectomy studies have not pursued the role of clinical variables on linguistic outcomes. | | | These two problems are not independent: until we systematically factor in clinical variables on the effects of hemispherectomy on language, we will not be able to make sense of relevant conflicts in the literature. |
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http://www.humnet.ucla.edu/humnet/linguistics/people/curtiss/HemiPub.doc
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| | MWPH Provides Rehabilitation for Children After Hemispherectomy |
| | "The hemispherectomy patients who come to Mt. Washington Pediatric Hospital are not taught compensation techniques, instead they are forced to work with their limitations, which in turn strengthens their weakened areas," says Susan Dubroff, director of rehabilitation. | | | For these children re-entering a life free from seizures begins with learning new pathways to the brain through forcing the use of their weak extremities. | | | Generally, each child requiring rehabilitation has a two week inpatient stay, where the team of therapists, nurses, physicians and psychologists/neuropsychologists assist in teaching them one-handed grooming activities, as well as regaining visual, oral and verbal communication skills to some level. |
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http://www.mwph.org/news/061903.html
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| | Children's Hemiplegia and Stroke Association |
| | Page content written by Kelli Suzuki, parent of a child who has had a hemispherectomy. | | | Seizures and Epilepsy in Childhood A Guide for Parents by John M. Freeman, MD Seizure Freedom by Leanne Chilton - This book gives you a good look at living with seizures and undergoing brain surgery from an adult's point of view. | | | Some children may experience changes in their behavior (good and bad) since their ability to control their |
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http://www.chasa.org/hemispherectomy.htm
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| | October issue.indd |
| | These techniques promise to lessen the risks associated with the more destructive procedures, but whether they have the same epilepsy control rates as the resective surgery remains to be elucidated. | | | This is a minimally invasive approach to epilepsy which has been discussed above as an alternative to hemispherectomy, and disconnection is also being assessed as an alternative to temporal lobectomy. | | | Surgery for focal temporal lobe seizures has become one of the most successful therapeutic procedures in neurosurgery today. |
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http://www.rcsed.ac.uk/journal/vol47_5/47500001.html
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| | Rasmussen Syndrome / Family Village Library |
| | A central theme is the hemispherectomy surgical procedure. | | | Many of us have had experience with hemispherectomy procedure with our children. | | | We are a group of families that share information about our experiences in dealing with neurological problems relating to children. |
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http://www.familyvillage.wisc.edu/lib_rs.htm
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| | Psycoloquy 10(002): Human Evolution Expanded Brains to Increase Expertise Capacity, not iq |
| | I propose that the advantage may be related to increased capacity for an aspect of intelligent behaviour not measured by IQ tests but critical to the survival of our simple hunter-gatherers ancestors: the capacity to develop expertise. | | | This advantage might be associated with increased IQ, but there is a problem: evidence from MRI volumetric surveys, microcephaly and hemispherectomy shows that there exist individuals with psychometrically normal IQ but Homo-erectus-sized brains. | | | Why did evolution increase brain size (with its associated costs) when humans (as these individuals demonstrate) can have normal IQ without bigger brains? |
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http://www.cogsci.soton.ac.uk/cgi/psyc/newpsy?10.002
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| | Psychopathology of speech |
| | His expressive speech was limited similar to a stroke patient; but he was able to respond to simply worded questions, and was fully attuned to his environment and immediate needs. | | | Since Dandy did the first hemispherectomy on a glioma patient there has been continuous research in this radical intervention and its speech after-effects. | | | This may be associated to redundant right brain areas imbued with functions of tonal and musical qualities consistent with J.H. Jackson’s classic views of unequal but bilateral cerebral representation. |
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http://www.priory.com/psych/speech.htm
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| | Referrals |
| | Functional hemispherectomy is not associated with delayed complications and is now the procedure of choice in patients with infantile hemiplegia, if the hemiplegia is complete. | | | Modified, or functional hemispherectomy was then introduced as a surgical option for these patients. | | | A full range of diagnostic and therapeutic options for patients with medically refractory epilepsy are available at the Dartmouth-Hitchcock Medical Center. |
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http://www.dhmc.org/webpage.cfm?site_id=2&org_id=128&morg_id=0&sec_id=0&gsec_id=4774&item_id=4774
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| | Functional Hemispherectomy |
| | Most people who have a functional hemispherectomy will be able to return to their normal activities, including work or school in 6 to 8 weeks after surgery. | | | Muscle weakness on the affected side of the body | | | This procedure generally is used only for people who do not experience improvement in their condition after taking medication and who have severe, uncontrollable seizures beginning in a non-functioning hemisphere. |
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http://my.webmd.com/content/article/88/99676.htm
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| | Developmental neuroplasticity in a model of cerebral hemispherectomy and stroke. |
| | We argue that this period of reduced brain vulnerability to injury also exists in other higher mammals, including man, and suggest ways to enhance restorative processes after stroke/hemispherectomy occurring at other ages. | | | Additional evidence strongly suggests that the remodeling underlies the outstanding behavioral and functional recovery/sparing following early cerebral hemispherectomy. | | | Developmental neuroplasticity in a model of cerebral hemispherectomy and stroke. |
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http://www.arclab.org/medlineupdates/abstract_10670431.html
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| | Mapping Movement; Amy Bastian |
| | "That shows us the brain is adapting!" What's exciting is that the hemispherectomy patients and stroke patients Bastian's had on the treadmill are also able to adapt-an important sign cerebellar learning is kicking in. | | | It's a result, she believes, of the way the damaged cortex alters how the spinal cord and brainstem process walking information. | | | Recording what's normal when you walk or reach gives a telling contrast in disease. |
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http://www.neuro.jhmi.edu/BrainWaves/2004_Fall/Bastian.htm
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| | Weill Cornell Department of Neurology and Neuroscience |
| | Hemispherectomy is another form of epilepsy surgery unique to children. | | | These children are also born with, or develop, severe weakness or motor impairment on one side of their body, again reflecting severe dysfunction in the affected hemisphere of the brain. | | | Although hemispherectomy involves a more extensive approach than surgeries considered for adults, the unique ability of a young child's brain to re-organize, to re-assign important functions, and to relearn tasks - known as plasticity - renders hemispherectomy a safe surgical tool for treatment of childhood epilepsies with diffuse hemispheric involvement. |
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http://www.med.cornell.edu/neuro/patient_care/epilepsy_center/ne-pediatsurg.html
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| | Surgery for Intractable Epilepsy |
| | There is only limited evidence that cerebral hemispherectomy is effective in managing unilateral multifocal epilepsy associated with infantile hemiplegia (especially in hemimegalencephaly and Sturge-Weber disease). | | | Corpus callosotomy has been found to be safe and effective for treating patients with partial and secondarily generalized seizures. | | | There must have been an adequate period of drug therapy, namely, the correct drugs used in the correct dosage, carefully monitored for treatment effects and members' compliance. |
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http://www.aetna.com/cpb/data/CPBA0394.html
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| | Vining: Why would you remove half a brain? |
| | In children with dysplasias, early surgery can allow the resumption of more normal development. | | | Conclusion: Hemispherectomy can be a valuable procedure for relieving the burden of seizures, the burden of medication, and the general dysfunction in children with severe or progressive unilateral cortical disease. | | | The outcome of 58 children after hemispherectomy - the Johns Hopkins experience: 1968 to 1996. |
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http://cogweb.ucla.edu/Abstracts/Vining_97.html
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| | Patient Education Reports - UMMC |
| | This local surgery, which can cure the patient's epilepsy, has become possible with the advent of advanced imaging techniques such as MRI. | | | Other surgical procedures called hemispherectomy and corpus callosotomy offer hope for infants and young children with catastrophic seizures that occur in one or part of a hemisphere and for patients whose seizures are due to certain structural brain abnormalities or tumors. | | | Surgery can take 12 hours and there is always some paralysis on one side of the body. |
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http://www.umm.edu/patiented/doc44surgery.html
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| | CONCLUSION: This case demonstrates how cerebral oximetry can be used to give quantitative evidence of cerebral hypoxia, thus showing that immediate surgical intervention is necessary. | | | Low-pressure hydrocephalic state (LPHS) has only recently been described as a distinct clinical entity occurring in patients with bioatrophic lesions of the brain. | | | We report a patient in whom this syndrome developed after subtotal hemispherectomy for intractable epilepsy. |
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http://www.viagenbio.com/ref-surgery-2/surgery-2-research-abs6.17.html
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| | Hemispherectomy Family Reunion July 14-17, 2005 |
| | I am Ellen Webster, the mother of an 8-year-old child who as an infant had a left hemispherectomy. | | | We will have speakers and workshops for families, siblings, parents, and those that are directly affected by a hemispherectomy. | | | But as those of you have attended a reunion in the past know that the most-important parts of our gatherings are the times we spend with others on similar paths. |
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http://home1.gte.net/vze7s8mu
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| | »»Anatomy Reviews«« |
| | Antonio M. Battro deserves credit and reading for this extremely concise and informative authoritative introduction to hemispherectomy & brain research in general. | | | Battro's insightful, inspirational, and sensitive study of a young boy whose functional hemispherectomy has left him with only a functioning left side of his brain is a challenge to many preconceptions regarding the limitations of the human brain and its adaptability. | | | The successful adaptations made by the subject of the book, Nico, with the aid of computer technology to succeed in a regular academic environment will call into question standard lesion analysis in projecting the capabilities and potential of others who have undergone this surgery. |
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http://www.health-issue-books.com/Anabolic-Steroids/Anatomy/Anatomy_24.html
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| | Study confirms benefits of hemispherectomy surgery |
| | Email the release "Study confirms benefits of hemispherectomy surgery." | | | The information will not be used for any other purpose. | | | Your e-mail address, and that of your recipient(s), will be used only to let the recipient(s) know who sent the link and in the case of transmission errors. |
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http://www.eurekalert.org/emailrelease.php?file=jhmi-scb101303.php
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| | PREOP.HTML |
| | A: no, problem with right hemispherectomy is weakness and sensory loss left side and left visual field loss | | | Q: Is hemispherectomy the only way to stop it? | | | Q: If a hemispherectomy is performed, is there any possibility of left hemisphere eventually needing resection/removal? |
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http://www.uslink.net/~mhutson/My_Pre-Op_Questions.htm
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| | CWL Publishing Enterprises |
| | I.N. Mensh, H.G. Schwartz, R.G. Matarazzo, and J.D. Matarazzo, "Psychological Functioning Following Cerebral Hemispherectomy in Man," Archives of Neurology and Psychiatry, 1952, 67, p. | | | Howard Gardner, L.J. Karnosh, C.C. McClure, Jr., and A.K.Gardner, "Residual Function Following Hemispherectomy for Tumour and Infantile Hemiplegia," Brain, 1955, 78, pp. | | | Peggy S. Gott, "Language after Dominant Hemispherectomy," Journal of Neurology, Neurosurgery, and Psychiatry, 1973, 36, p. |
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http://www.cwlpub.com/notes.htm
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| | Gazzaniga |
| | Wessinger, C.M., Fendrich, R., Gazzaniga M.S., Ptito, A. and Villemure, J-G. Extrageniculostriate Vision in Humans: Investigations with Hemispherectomy Patients. | | | Wessinger CM, Fendrich R and Gazzaniga MS, Ptito A and Villemure J-G. (1996) Extrageniculostriate Vision in Humans: Investigations with Hemispherectomy Patients. | | | C.M. Wessinger, R. Fendrich, A. Ptito, J.-G. Villemure, M.S. Gazzaniga (1996) Residual Vision with Awareness in the field contralateral to a partial or complete functional hemispherectomy. |
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http://www.dartmouth.edu/~cogneuro/Gazzaniga.html
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| | Guest Book: Re: Fairfax, VA |
| | It has been frustrating locating available therapists and or centers. | | | My 9-yr old son is currently receiving inpatient PT, OT and ST and soon will require out-patient speech therapy at least three times each week. | | | He recently had a hemispherectomy and is re-learning speech, although he is progressing well, he will require more help before returning to school in the fall. |
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http://members3.boardhost.com/visitorsbook/msg/991.html
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| | Functional Hemispherectomy |
| | Hemispherectomy also is performed on patients who have hemimegalencephaly, Sturge-Weber or Rasmussen's encephalitis. | | | Hemispherectomy leads to seizure control in about 80 percent of patients. | | | In summary, functional hemispherectomy provides a relatively safe surgical procedure for patients who have a damaged cerebral hemisphere producing medically intractable epilepsy. |
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http://www.neuro.wustl.edu/epilepsy/pediatric/articleHemispherectomy.html
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| | [No title] |
| | Cerebral hemispherectomy in pediatric patients with epilepsy: comparison of three techniques by pathological substrate in 115 patients. | | | Few studies have been conducted to compare whether there are perioperative differences based on hemispherectomy technique and/or pathological substrate in pediatric patients with epilepsy. | | | In addition, cases involving cortical dysplasia and Rasmussen encephalitis are being identified and surgically treated in younger individuals. |
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http://www.find-health-articles.com/article-14758940-cerebral-hemispherectomy-pediatric-patients-epilepsy-comparison.htm
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| | Hemispherectomy - Wikipedia, the free encyclopedia |
| | All hemispherectomy patients suffer at least partial hemiplegia on the side of the body opposite the removed or disabled portion, and may suffer problems with their vision as well. | | | Hemispherectomy is a surgical procedure where one cerebral hemisphere (half of the brain) is removed or disabled. | | | This procedure is used to treat Rasmussen’s syndrome, and children who have suffered disabling strokes or with exceedingly frequent seizures. |
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http://en.wikipedia.org/wiki/Hemispherectomy
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| | Eric Kossoff, MD |
| | Kossoff's clinical and research interests include the ketogenic diet, infantile spasms, hemispherectomy, migraine headaches, neuro-infectious diseases (Lyme, Neurocysticercosis, encephalitis), pseudotumor cerebri, and Sturge-Weber syndrome. | | | His clinical practice specializes in the diagnosis and treatment of childhood seizures and epilepsy, including the surgical treatment of epilepsy, as well as other disorders of child neurology. | | | Hemispherectomy for Sturge-Weber Syndrome: Indications and outcomes of 32 cases worldwide. |
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http://www.neuro.jhmi.edu/profiles/kossoff.html
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| | News - Hemispherectomy Appears Safe And Effective For Children With Epilepsy |
| | A DGReview of : "Clinical outcomes of hemispherectomy for epilepsy in childhood and adolescence." | | | Hemispherectomy for the treatment of epilepsy is effective in children up to age 17, according to a retrospective review. | | | Most of the children who underwent this procedure had improvements in their epilepsy symptoms, and none experienced significant surgery-related cognitive or language deficits. |
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http://www.docguide.com/news/content.nsf/news/8525697700573E1885256CC5004EB533
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| | Epilepsy surgery in children and adolescents |
| | Success rates, defined as no postoperative seizures with loss of consciousness (Engel Grades I and II) were 78% in 52 patients treated by temporal lobectomy, 75% in eight patients who had extratemporal resections, 80% in 10 children treated by hemispherectomy, and 33% in three patients treated by corpus callosotomy. | | | Falconer MA, Rushworth RG: Treatment of encephalotrigeminal angiomatosis (Sturge-Weber disease) by hemispherectomy. | | | The application of the principles of surgical management of intractable epilepsy to children is a relatively recent phenomenon.[2,4] The previous supposition was that a child might "outgrow" a seizure disorder or that passage through puberty might produce unpredictable changes in the seizure disorder. |
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http://www.c3.hu/%7Emavideg/jns/1-5-1.html
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| | Rasmussen's Syndrome : Epilepsy.com |
| | Immunologic therapies (gamma globulin, plasmapheresis) may be helpful in some cases. | | | Despite the drastic nature of hemispherectomy, where half of the brain is removed, the surgery can be highly effective in stopping the seizures and preventing mental impairment. | | | In children with severe weakness and loss of touch and vision on the side of the body opposite the involved hemisphere of the brain, a surgical procedure called a functional hemispherectomy may be successful. |
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http://www.epilepsy.com/epilepsy/epilepsy_rasmussens.html
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| | Final Diagnosis -- Case 326 |
| | Villemure J-G., Andermann F., and Rasmussen T.B. (1991) Hemispherectomy for the treatment of epilepsy due to chronic encephalitis. | | | The treatment of choice is functionally complete hemispherectomy with complete disconnection of the frontal and occipital lobes (7, 8). | | | The outcome of 58 children after hemispherectomy-the Johns Hopkins experience: 1968 to 1996. |
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http://path.upmc.edu/cases/case326/dx.html
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| | Hemispherectomy : Epilepsy.com |
| | Hemispherectomy is only considered for patients (usually children) who have severe epilepsy with seizures arising from only one side of the brain. | | | This procedure is called "functional hemispherectomy." There are several variations in the procedure. | | | Hemispherectomy involves disconnecting one side of the brain (that is, one cerebral hemisphere) from the rest of the brain. |
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http://www.epilepsy.com/epilepsy/hemispherectomy.html
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| | Congress of Neurological Surgeons - Publications |
| | It may be appropriate treatment for children with Rasmussen's syndrome (a condition involving progressively worse seizures) and for children with uncontrollable seizures due to developmental abnormalities or strokes involving one side of the brain. | | | There are also risks of hydrocephalus that may require a shunt. | | | Alex's seizures were caused by a developmental brain condition that began in utero (while she was in the womb). |
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http://www.neurosurgeon.org/publications/detail.asp?PressID=12
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| | Hemispherectomy |
| | These conditions badly damage one side of the brain, cause frequent seizures and problems with physical and mental development, and do not respond well to drug treatment. | | | This procedure is sometimes done on children who have severe forms of epilepsy, such as Rasmussen syndrome and Sturge-Weber disease. | | | The surgery always causes some loss of movement and sensation on one side of the body and sometimes causes partial loss of vision in half of the visual field of each eye. |
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http://www.universityhealth.org/114224.cfm
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| | Seizure disorder |
| | This procedure, an alternative to hemispherectomy in patients with congenital hemiplegia, removes some or all of the white matter that separates the two halves of the brain. | | | This method of removing brain tissue is restricted to patients with severe epilepsy and abnormal discharges that often extend from one side of the brain to the other. | | | Hemispherectomies most often are performed on infants or young children who have had an extensive brain disease or disorder since birth or from a very young age. |
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http://www.healthatoz.com/healthatoz/Atoz/ency/seizure_disorder.jsp
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| | Hemispherectomy type (anatomic versus functional versus hemidecortication) did not influence outcome. | | | Age at surgery did not have an adverse effect on either seizure or cognitive outcomes. | | | OBJECTIVE: To examine the natural history of patients who underwent hemispherectomy and identify the outcomes in terms of seizure reduction, cognition, and motor deficits. |
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http://www.dreampharmaceuticals.com/ref-hemorrhage/hemorrhage-research-abs5.166.html
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| | Study confirms benefit of surgery for epilepsy --- HealthandAge |
| | The follow up study shows that after hemispherectomy, 86 per cent of the patients were either completely free of seizures or at least had non-disabling seizures that didn't require medication. | | | Removal of half of the brain is a successful way of controlling very severe forms of epilepsy. | | | This study shows that this drastic operation is one that can bring great benefits to children whose quality of life would otherwise be severely compromised by epilepsy. |
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http://www.healthandage.com/Home/gm=6!gid1=4960
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| | Psycoloquy 4(62): Distinctions: Subpersonal and Subconscious |
| | According to Puccetti, Dennett is committed to the view that "the left hemispherectomy patient is no better off than the neocortical death patient... | | | And, to (nearly) repeat an earlier point, there is no reason to assimilate the morality of killing such a subject with the morality of killing a decorticated subject. | | | This implies a view of the hemispherectomy case raised earlier: one part-person and part-consciousness but not more, we think. |
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http://www.cogsci.soton.ac.uk/cgi/psyc/newpsy?4.62
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