Gait is not affected by hemispherotomy - case report from two children.

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 three years of life and were treated with a hemispherotomy at about seven 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 3D gait analysis. However, greater deviations to controls post-operatively may also be related to day-to-day variability.