Hemispheric Surgeries to Treat Seizures In Kids

A common type of surgery that helps stop seizures in epilepsy is a hemispheric surgery.

Hemispheric surgeries completely disconnect one half of the brain from the other. This prevents seizures from spreading to the other half of the brain.

Many surgeries fall under the group of hemispheric surgeries.

These procedures differ in distinct ways:

• The amount of brain tissue removed.
• The brain areas the surgeon disconnects.
• How the surgeon approaches the surgery.

At UPMC Children's Hospital of Pittsburgh, epilepsy surgeons are experts in hemispheric surgeries. They've used them to treat many different epilepsy diagnoses in kids.

What Is Functional Hemispherotomy in Children?

One common type of hemispheric surgery is a functional hemispherotomy.

Largely, hemispherotomy surgery:

• Is for children whose seizures start on only one-half of the brain. The half that doesn't work right often adversely affects how the whole brain works.
• Disconnects the unhealthy hemisphere of the brain from the healthy one.
• Stops seizures from spreading to the other, healthy half of the brain.

What happens during hemispherotomy?

During a hemispherotomy, your child's surgeon:

• Opens the scalp and takes off a piece of the skull.
• Removes some parts of the brain and cuts the connection between other parts. They disconnect the corpus callosum to stop the spread of seizures.
• Puts the skull piece back in place and stitches the scalp closed.

The surgery takes about 4 to 6 hours.

What to expect after hemispherotomy surgery

After surgery, your child will be in the intensive care unit (ICU). They'll stay there for at least one night while our care team watches them the whole time.

Our team will check their blood pressure, pulse, and breathing often.

When your child is stable enough, the care team will move them to another nursing unit. They'll be in the hospital for another 5 to 7 days.

They may also need some rehabilitation to speed up their recovery. This could be in the hospital or after discharge.

Our surgery team will watch your child closely over the next few months to:

• Make sure your child is healing as they should.
• See what effect surgery had on their seizures.
• Check for any long-lasting post-op complications.

Potential complications of hemispherotomy in kids

As with any surgery, complications can happen during hemispherotomy.

The major problems are bleeding and infection.

Other issues this surgery can cause are:

• Visual field loss.
• Some loss of fine motor skills.
• Weakness on the opposite side of the operation site.

Your child's care team will test your child before and after surgery to watch for any changes in function.

But many kids function well with only half a brain. The healthy half of the brain takes over many of the jobs of the severed half.

Kids adapt better the younger they are when they have the surgery. Their brains are more flexible and able to compensate for losing one-half of the brain.

Contact the Epilepsy Surgery Program at UPMC Children's Hospital of Pittsburgh

To make a referral, schedule an appointment, or request an evaluation for a child or teen:

• Call 412-692-6928.
• Email epilepsysurgery@chp.edu