Does your little child have seizures often? You might feel very sad and worried when medicines do not stop the fits. Sometimes, doctors talk about a big surgery called a hemispherectomy when medicines fail. Hearing this name can make you feel very scared because it means removing half of the brain. Do not worry today. We will talk about this in a very simple way that you can easily understand.
Deciding on brain surgery for your child is one of the hardest things you will ever do. You want to know if it is safe and if it will truly help your child live a better life. Let us walk through what this surgery is, who needs it, and how your child can heal.
Key Takeaways About Hemispherectomy
- Hemispherectomy is a brain surgery used for children with severe epilepsy that does not respond to any medicine.
- Up to 80% of children who have this surgery stop having seizures completely or get much better.
- The healthy side of the brain can often take over many functions of the removed side over time.
- Physical, occupational, and speech therapy are very important to help your child recover and grow strong.
- Always talk openly with your doctor and care team about every worry or question you have.
Simply Put, What is a Hemispherectomy?
A hemispherectomy is an operation where a surgeon removes or disconnects one half of a child's brain. The word "hemi" means half. This is a very rare and specialized surgery performed by expert neurosurgeons.
Doctors perform this surgery mainly for children who have epilepsy that medicines cannot control at all. In these children, one side of the brain is abnormal and causes constant seizures. Removing or disconnecting that sick part helps stop the seizures so your child can grow and learn.
There Are Two Main Types of This Surgery
Surgeons use two main methods for this procedure. Your doctor will look at your child's specific medical condition to choose the safest and best method.
| Surgery Type | What It Means in Simple Words |
|---|---|
| Functional Hemispherectomy | The surgeon removes a small part of the sick side of the brain and disconnects the nerve pathways between the sick side and the healthy side. Doctors do not remove a massive piece of the brain here, which lowers the risk of problems. Doctors usually try this method first. |
| Anatomic Hemispherectomy | The surgeon removes all four main lobes on the sick side of the brain. Doctors may choose this if the functional surgery does not stop the seizures. This type has a slightly higher risk of heavy bleeding or other complications. |
The most important thing is that both methods have a very similar success rate. Both are very good at stopping dangerous seizures.
What Kind of Children Need This Surgery?
Doctors do not perform this surgery for every child who has seizures. They only use it in very specific situations. Your doctor might consider this surgery if your child has the following signs or conditions:
- Epilepsy or seizures that do not stop with any seizure medicine.
- Weakness on one side of the body, such as not being able to use one hand like the other.
- Loss of peripheral vision on one side.
- An MRI brain scan showing a problem on only one side of the brain.
- Delayed growth and development because of constant, daily seizures.
Medical Conditions That Can Cause These Symptoms
- Malformations of Cortical Development: Issues that happen when the outer layer of the brain forms incorrectly before birth.
- Perinatal Infarction (Stroke): A stroke that happens while the baby is in the womb or right around the time of birth.
- Hemimegalencephaly: A condition where one side of the brain grows much larger than the other side.
- Sturge-Weber Syndrome: A rare disorder featuring abnormal blood vessel growth that can affect the brain.
- Rasmussen Encephalitis: A rare inflammatory disease that affects only one side of the brain and causes frequent seizures.
What Happens Before and During the Surgery?
Preparing your child for such a big surgery can feel like a huge challenge for you. But the doctors and nurses at the hospital will guide you through every step with care.
Before the Surgery
The night before the operation, nurses will tell you when your child must stop eating and drinking. Your care team will give you clear instructions on which medicines to stop and which ones to keep giving. Nurses may shave a small part of your child's hair near the surgical area on their head.
During the Surgery
Doctors will give your child general anesthesia so they sleep deeply and feel no pain. The surgery takes about five hours, and sometimes longer. The surgeon follows these main steps:
- Removing a small piece of the skull to reach the brain. Doctors call this a craniotomy.
- Removing or disconnecting the sick brain tissue safely.
- Cutting the nerve fibers that connect both sides of the brain, called the corpus callosum.
- Putting the piece of the skull back in place and closing the skin neatly with stitches.
What Happens After Surgery and How Are the Results?
After the surgery, nurses will move your child to the pediatric intensive care unit (PICU) to watch them very closely. After two or three days, doctors will move your child to a regular hospital room.
The best news is that results from this surgery are very high. Studies show that 66% to 80% of children who have this surgery become completely free of seizures. Many other children see a huge drop in how often seizures happen.
A team of expert specialists will work hard to help your child recover and regain strength:
- Physical Therapy: Helps your child learn to walk, run, and balance their body safely.
- Occupational Therapy: Teaches your child everyday tasks like eating meals and getting dressed alone.
- Speech Therapy: Helps your child overcome talking difficulties and express their thoughts clearly.
Are There Any Risks and Complications?
Like any major surgery, this operation has some risks and complications. However, serious problems happen very rarely.
| Complication Timing | Description and Details |
|---|---|
| Early Complications | Can happen during surgery or shortly after. Examples include heavy bleeding, wound infections, or low body temperature. Doctors monitor your child constantly to prevent and treat these quickly. |
| Later Complications | The main concern is a condition called hydrocephalus, where extra fluid builds up inside the brain. This happens in less than 5% of functional surgeries. If this occurs, doctors can place a tiny tube called a shunt to drain the extra fluid safely. |
When to Call the Doctor Right Away
After your child goes home from the hospital, watch them very closely. Call your doctor right away or go to the nearest emergency department (ER / A&E) if you notice any of these warning signs:
- Signs of infection such as fever, swelling around the surgical cut, redness, or pus draining.
- Frequent vomiting, severe headache, or unusual behavior changes, which can point to hydrocephalus.
- Any return of seizures or fits.
Making a choice about this surgery is never easy for parents. It feels like a heavy weight on your heart. But remember that a doctor only recommends this type of surgery when no other choices remain and when it will truly give your child a better life.
A Note from Dr. Priya Sammani
As a medical editor and patient advocate, I know how frightening childhood epilepsy can be for families. Deciding on brain surgery feels overwhelming. Please trust your medical team, ask every question on your mind, and remember that you are your child's greatest hero. Modern pediatric neurosurgery offers real hope for children who previously had no answers.
Sources & References
- Cleveland Clinic. (2024). Hemispherectomy: Procedure, Recovery & Outlook. Retrieved from medical literature and clinical guides.
- Mayo Clinic. (2025). Epilepsy Surgery and Pediatric Neurosurgery Care. Retrieved from patient care guidelines.
- National Health Service (NHS UK). (2025). Epilepsy surgery in children and young people. Retrieved from health information portal.
- Centers for Disease Control and Prevention (CDC). (2024). Epilepsy in Children Basics. Retrieved from public health guidelines.
- National Institutes of Health (NIH) / PubMed. (2023). Long-term outcomes of functional and anatomic hemispherectomy in pediatric drug-resistant epilepsy. DOI: 10.1016/j.seizure.2023.05.012.
💬 Comments (0)
No comments yet. Be the first to share your thoughts here.
Add Your Comment