Neurologists and neurosurgeons at Johns Hopkins have been in the forefront of re-popularizing hemispherectomy for the treatment of particularly severe seizures generated by one side of the brain. A radical procedure in which half of the brain is removed, this surgery is considered only for individuals with seizures originating in one side of the brain, when medications cannot control the seizures. Hemispherectomy may be the appropriate treatment for children with Rasmussen's syndrome, and for children with uncontrollable seizures due to developmental abnormalities or strokes involving one side of the brain. At Hopkins, chief of pediatric neurosurgery, Benjamin Carson, M.D., leads the surgical team that performs the often 12-hour procedure. After a period of rehabilitation, children are able to walk and run with only a limp, and perhaps an ankle brace.
Children generally experience no intellectual impairment.
Some patients have improve academically when their seizures stopped and they were able to reduce or stop anticonvulsant medication. The vagus nerve stimulator, a silver-dollar sized device, is surgically implanted on the chest near the collarbone and gives off periodic electrical impulses through a wire wrapped around the vagus nerve in the neck. Epilepsy and the Ketogenic Diet Having treated more than 450 children with the diet, Hopkins researchers have and are continuing to publish studies of the diet's effectiveness, side effects and complications. With psychologists, they are evaluating the effects of the diet on intelligence and family stress. Studies of the effects on kidney function are ongoing, as are studies of the relation of blood ketone bodies and seizure control.