Growing up without a right hemisphere

Research on the neuropsychological outcomes of hemispherectomy in childhood has largely focused on the development of language after surgery to the left hemisphere. That work has highlighted both the positive aspects of neural plasticity in that language representation is transferred to the right hemisphere and the negative aspects - the crowding effect- in that aspects of visual-spatial processing may suffer. Less is known about the effects of right hemispherectomy on cognitive development, particularly on visuospatial processing, with existing studies including samples that vary considerably in etiology, age of seizure onset, duration of epilepsy, and age at surgery. This case report discusses neuropsychological development at ages 6 and 10 years in a young boy who underwent a right hemispherectomy at 6 months of age. Despite an extended period of seizure-free development of the left hemisphere, there was no evidence for reorganization of visuospatial function, as he remained impaired on tests assessing his ability in that domain. Findings suggest that the left hemisphere has limited capacity to assume the visual-spatial functions usually associated with the right hemisphere.