Gait is not Affected by Hemispherotomy-Case Report from Two Children

Area of Science:

• Pediatric Neurology
• Neurosurgery
• Rehabilitation Medicine

Background:

• Epilepsy in children often requires advanced treatment strategies when standard therapies fail.
• Hemispherotomy, a surgical hemisphere disconnection, is a recognized option for severe, intractable epilepsy.
• Previous research on hemispherotomy primarily focused on visual and upper limb function, with limited quantitative data on gait.

Observation:

• This study involved two pediatric patients with structural, therapy-refractory epilepsy and prenatal ischemic brain lesions.
• Both patients underwent hemispherotomy around age seven.
• Quantitative three-dimensional gait analysis was performed pre- and post-operatively as part of routine care.

Findings:

• One patient exhibited no significant alterations in gait pattern after hemispherotomy.
• The second patient demonstrated observable differences in gait parameters post-surgery, as detected by three-dimensional gait analysis.
• Postoperative gait deviations in the second patient might be influenced by natural day-to-day variability.

Implications:

• Quantitative gait analysis provides valuable insights into the functional outcomes of hemispherotomy beyond traditional assessments.
• The variability in gait responses suggests individualized patient factors influence post-surgical motor function.
• Further research with larger cohorts is needed to fully understand the long-term effects of hemispherotomy on gait and to establish normative data.