Hemispherectomy for the treatment of epilepsy and behavior disturbance

This study is based on 28 personal cases. Twenty seven cases of infantile hemiplegia and one case of Stürge-Weber syndrome, with uncontrollable epilepsy and severe behaviour disturbance, were subjected to hemispherectomy. Any evidence of a defect in the other hemisphere was a contraindication to operation. In nine cases the left cerebral hemisphere was removed. Following the operation, epilepsy and behavior disturbances were abolished in nearly all of the cases. In those with left hemispherectomy there was no speech disturbance before or after the operation. It is postulated that at birth all cerebral functions including consciousness, speech, and movement are bilaterally represented, but to unequal degrees. With training and education these functions become more lateralized. Thus, we can explain the greater plasticity of the brain in childhood.