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Motor cortex relocation after complete anatomical hemispherectomy for intractable epilepsy secondary to Rasmussen's
Mitchell T Foster1, Kumar Das1, Paul May1
1a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool , UK.
British Journal of Neurosurgery
|January 18, 2019
Summary
A hemispherectomy for Rasmussen's encephalitis enabled a young patient to regain motor function and cognitive abilities. This case highlights remarkable neuroplasticity and functional recovery after brain surgery.
Area of Science:
- Neurosurgery
- Neuroscience
- Epileptology
Background:
- Report of a pediatric case with Rasmussen's encephalitis, a rare autoimmune neurological disease.
- Medically refractory epilepsy managed with complete anatomical hemispherectomy.
Observation:
- A seven-year-old female underwent a right-sided anatomical hemispherectomy.
- Eleven years post-surgery, the patient exhibited independent mobility with upper limb spasticity.
- Normal intellect and pursuit of higher education were noted.
Findings:
- Seizure relief achieved post-hemispherectomy.
- Functional MRI demonstrated motor control re-localization to the remaining left hemisphere.
- The contralateral hemisphere showed existing neural architecture supporting motor function.
Implications:
- Demonstrates significant neuroplasticity in pediatric epilepsy surgery.
- Highlights the brain's capacity to reorganize motor control post-hemispherectomy.
- Suggests potential for functional recovery and higher cognitive function after extensive brain surgery.