Epilepsy is an overwhelming disease, causing a variety of symptoms.  Seizure, a major symptom of epilepsy, induces temporary confusion, staring into space, rapid blinking, involuntary tongue or mouth movements, stiffening and loosening of muscles, loss of consciousness, and uncontrollable convulsive body movement. One understands how each of these symptoms will bewilder a child and put their life in disarray.

A life-altering disease, epilepsy is experienced by 1.2% of our nation, approximately 3.8 million people.  The most common treatments include medication, surgical insertion of a device to emit electrical signals to the brain, and brain surgery.  The treatment used depends on the type of epilepsy experienced by a patient. 

Focal epilepsy is the type where seizures develop on one side of the brain.  These seizures cannot always be controlled with medication or electrical stimulation, and the severity and frequency will damage the healthy regions of the brain. In these circumstances a neurosurgeon may become part of the patient’s treatment team and decide to treat the disease by entirely removing the half of the brain where seizures originate. A hemispherectomy, the medical term for this procedure, is only performed on young children whose remaining hemisphere will be able to recover, adapt, and even reinvent.

A hemispherectomy calls for a surgeon toe cut and remove a portion of the skull and underlying tissue, sever nerves and other tissue connecting the two hemispheres, remove the unhealthy hemisphere, and repair the portion of skull removed.  Cerebrospinal fluid with fill the portion of the skull left vacant within 1-2 days.  The youngest patient to undergo this surgery was 3 months old and is seldom performed on children over 10 years of age.

I would be overwhelmed with terror and panic were I told my child was to be treated by removing half of their brain.  This thought seems bizarre but is occasionally required for the long-term benefit of the child. Wonderfully the brain is amazing and there are astonishingly good outcomes.

Recovering in 6 to 8 weeks, personality and memory are left remarkable undamaged.  Patients are high functioning with age-appropriate language skills and enjoy a great improvement of life. A study comparing such patients with non-epileptic people found nerve connectivity to often be greater in the patients. One patient who underwent a hemispherectomy went on to become a state chess champion.

Unfortunately, the surgery does have negative impacts. The hemispheres of the brain control opposite sides of the body, so the surgery may result in loss of vision in one eye and function in the arm on the opposite side.  Choosing between these side effects and daily debilitating seizures should be a “no brainer”.