ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2020
Multimodal assessment of motor pathways and intracortical connections in functional hemispherectomy.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 8 citations in OpenAlex.
- Motor Recovery After a Hemispherectomy: Review of Mechanisms and the Potential of Neuromodulation to Enhance Motor Outcomes.Journal of child neurology · 2026Review
- The impact of brain lesion characteristics and the corticospinal tract wiring on mirror movements in unilateral cerebral palsy.Scientific reports · 2022Article
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7 authors at 6 institutions in 3 countries.
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Abstract
purposeFor selected children with medically intractable epilepsy, hemispherectomy can be an excellent treatment option and its efficacy in achieving seizure freedom or reduction in seizure frequency has been shown in several studies, but patients' selection could not be straightforward and often it is taken on subjective basis. We described a multimodal approach to assess patient eligible for hemispherectomy and possibly predicting post-surgical outcomes.
methodsWe describe pre- and post-surgical clinical features along with neuroradiological results by magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), MR-tractography (MRT), and neurophysiological study by single and paired pulses transcranial magnetic stimulation (TMS) in a child with cerebral palsy with epileptic encephalopathy, eligible for epilepsy surgery.
resultsPresurgical TMS evaluation showed a lateralization of motor function on the left motor cortex for both arms, and results were confirmed by MRI studies. Interestingly, after surgery, both epilepsy and motor performances improved and TMS showed enhancement of intracortical inhibition and facilitation activity.
conclusionFunctional hemispherectomy is an effective treatment for drug-resistant epilepsy, and multimodal presurgical assessment may be a useful approach to guide surgeons in selecting patients. Moreover, pre- and post-surgical evaluation of these patients may enhance our understanding of brain plasticity phenomena.
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