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Related Experiment Videos

Functional consequences of hemispherectomy.

R van Empelen1, A Jennekens-Schinkel, E Buskens

  • 1Department of Paediatric Physical Therapy and Exercise Physiology, University Medical Centre, Wilhelmina Children's Hospital, RM. KB 02.056.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands. R.vanEmpelen@wkz.azu.nl

Brain : a Journal of Neurology
|July 9, 2004
PubMed
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Hemispherectomy surgery significantly reduced seizure frequency and severity in children, leading to improved motor function and social participation. These gains in daily activities and epilepsy-related restrictions outweighed persistent motor impairments.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Hemispherectomy is a surgical option for severe pediatric epilepsy.
  • Understanding the long-term functional outcomes post-hemispherectomy is crucial for patient management.
  • The International Classification of Functioning, Disability and Health (ICF) provides a framework for assessing outcomes.

Purpose of the Study:

  • To evaluate the impact of hemispherectomy on impairments, activities, and social participation in children.
  • To assess changes in seizure control, motor function, self-care, mobility, and social function over a 2-year period.
  • To quantify epilepsy-related restrictions using validated scales.

Main Methods:

  • Longitudinal study of 12 children (mean age 5.9 years) before and up to 2 years after hemispherectomy.

Related Experiment Videos

  • Assessment of impairments: seizure frequency (Engel), seizure severity (HASS), muscle strength (MRC), range of motion (JAM), muscle tone (modified Ashworth).
  • Assessment of activities: gross motor functioning (GMFM), PEDI (self-care, mobility, social function).
  • Assessment of participation: epilepsy-related restrictions (HARCES).

    • Main Results:

    • 9/12 children achieved seizure freedom (Engel class I); 3/12 had Engel class III.
    • Significant improvements in seizure severity (HASS), gross motor functioning (GMFM: +20%), and PEDI scores (+20 scale points) were observed.
    • Motor impairments (strength, tone) showed temporary decline post-surgery but returned to baseline; range of motion remained impaired.
    • Epilepsy-related restrictions (HARCES) normalized in most children within 2 years.

    Conclusions:

    • Decreased seizure frequency and severity following hemispherectomy significantly enhance motor and social functioning.
    • Functional improvements in activities and participation can override residual motor impairments.
    • Hemispherectomy can lead to substantial gains in quality of life for children with severe epilepsy.