Abstract
In children with therapy refractory epilepsy, the functional disconnection of one
hemisphere (hemispherotomy) may be considered as a treatment option. The visual field
defects and hand function effects associated with the procedure have been extensively
studied. However, the effect of the hemispherotomy on gait pattern has thus far only
been analyzed qualitatively, and there is limited quantitative data. At the Children's
Hospital, we regularly perform standardized quantitative gait analysis studies and
care for children with complex epilepsies. During the standard routine of care for
two children with structural therapy refractory epilepsy, gait analysis was performed
prior to and after hemispherotomy. Both patients had prenatal ischemic brain lesions,
had developed severe epilepsy during the first 3 years of life, and were treated with
the hemispherotomy at about 7 years of age. Interestingly, one patient did not show
any changes in gait pattern, while for the other patient, differences could be observed
by means of three-dimensional gait analysis. However, greater deviations to controls
postoperatively may also be related to day-to-day variability.
Keywords
gait pattern - hemispherotomy - bilateral projection - cortico-spinal tract
