Long-Term Cognitive Improvement After Functional Hemispherectomy

BACKGROUND: To investigate intellectual development after functional hemispherectomy and to evaluate the favorable or unfavorable factors affecting prognosis. METHODS: Twenty-three patients from the patient follow-up database of the Epilepsy Center of Neurosurgery were selected for this retrospective study. The inclusion criteria of the patients were functional hemispherectomy surgery, surgical age older than 6 years, patients able to complete the intelligence assessment, follow-up time not less than 2 years, and availability of complete preoperative evaluation and postoperative follow-up data. Full Scale Intelligence Quotients (FSIQ) were calculated preoperatively and at the follow-up times for each patient. Correlations between the preoperative to postoperative changes in FSIQ and risk factors (age at epilepsy onset, duration of preoperative epilepsy, postoperative changes in the electroencephalogram, seizure status after surgery, and followup time) were analyzed. EpiData 3.1 software was used to establish a database and SPSS 22.0 software was used for data collation and analysis, and used the matching sample Wilcoxon symbol rank and test to conduct the analysis. RESULTS: The data of 23 patients were analyzed. The final follow-up results showed that 73.9% of the patients (17/23) had a significant increase in FSIQ scores (P = 0.006) after surgery, indicating that their cognitive function improved significantly. Successful surgery, successful postoperative seizure control, normalization of postoperative electroencephalogram, shorter disease duration before surgery, and longer recovery periods after surgery (follow-up time) were all related with good intellectual prognosis. CONCLUSIONS: Successful functional hemispherectomy significantly improved the cognitive function of patients. Functional hemispherectomy is a safe and effective treatment for patients with intractable epilepsy caused by hemispheric lesions and can effectively promote intellectual recovery and development.