Correlation between Hemispherectomy and Hemiparesis in Drug Resistant Epilepsy

BACKGROUND AND PURPOSE: Refractory epilepsy is when seizures are unresponsive to two or more medications. Hemispherectomy, one of the treatment options, is the complete removal or functional disconnection of a cerebral hemisphere. Hemiparesis, a symptom of epilepsy, is defined as weakness of one side of the body. Patients with refractory epilepsy, who experience extreme seizure frequency, are subjected to hemispherectomy. This study focuses on finding the correlation between hemispherectomy and hemiparesis, discovering a pattern in its severity levels before and after surgery. METHODS: Data was collected from 59 epileptic patients suffering from refractory epilepsy, who underwent hemispherectomy, at the King Faisal Specialist Hospital and Research Centre, from 1998 to 2014. Each patient was monitored over a period of 1-year post-surgery. In this study, we wanted to further explore the correlation between hemispherectomy and hemiparesis. RESULTS: Upon analyzing the sample size, the level of hemiparesis pre and post hemispherectomy remained the same for 32 patients, of which 13 patients had mild levels pre-surgery and 19 patients had moderate to severe levels pre-surgery. However, 20 of the patients who had moderate to severe levels of hemiparesis before the surgery had either no hemiparesis or a mild level after surgery, which signified an improvement in their severity level. On the other hand, seven of the patients went from having no hemiparesis before the surgery to having moderate or severe levels of hemiparesis post-surgery. Although the results were clinically significant, they were not statistically significant as the p-value obtained was 0.31. CONCLUSIONS: After analyzing the results, it can be concluded that hemispherectomy does decrease the severity of hemiparesis in an epileptic patient, thereby improving his/her quality of life drastically.