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    Case Analysis Bio

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    nuena estanislao
    A 21-year-old male presented with intractable seizures since infancy and left hemiparesis noted at age 2. He underwent a right frontoparietal craniotomy and functional hemispherectomy. Post-operatively, he was seizure-free for over a year and did not experience worsening of pre-existing deficits despite mild residual left-sided weakness. An fMRI showed a complete shift of motor function to the normal left hemisphere, explaining his good motor outcome despite the late presentation of weakness. The case demonstrates neuroplasticity following hemispherectomy.

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    Case Analysis Bio

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    nuena estanislao
    22 views2 pages
    A 21-year-old male presented with intractable seizures since infancy and left hemiparesis noted at age 2. He underwent a right frontoparietal craniotomy and functional hemispherectomy. Post-operatively, he was seizure-free for over a year and did not experience worsening of pre-existing deficits despite mild residual left-sided weakness. An fMRI showed a complete shift of motor function to the normal left hemisphere, explaining his good motor outcome despite the late presentation of weakness. The case demonstrates neuroplasticity following hemispherectomy.

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    A 21-year-old male presented with intractable seizures since infancy and left hemiparesis noted at age 2. He underwent a right frontoparietal craniotomy and functional hemispherectomy. Post-operatively, he was seizure-free for over a year and did not experience worsening of pre-existing deficits despite mild residual left-sided weakness. An fMRI showed a complete shift of motor function to the normal left hemisphere, explaining his good motor outcome despite the late presentation of weakness. The case demonstrates neuroplasticity following hemispherectomy.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    22 views2 pages

    Case Analysis Bio

    Uploaded by

    nuena estanislao
    A 21-year-old male presented with intractable seizures since infancy and left hemiparesis noted at age 2. He underwent a right frontoparietal craniotomy and functional hemispherectomy. Post-operatively, he was seizure-free for over a year and did not experience worsening of pre-existing deficits despite mild residual left-sided weakness. An fMRI showed a complete shift of motor function to the normal left hemisphere, explaining his good motor outcome despite the late presentation of weakness. The case demonstrates neuroplasticity following hemispherectomy.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    NEUROPLASTICITY IN HEMISPHERIC SYNDROME: AN INTERESTING

    CASE REPORT

    Estanislao, Nuena Y.

    ShyamSundar Krishnan, Manas Panigrahi, Sita Jayalakshmi, Dandu R Varma BS P-3A

    Year : 2011

    Source: http://www.neurologyindia.com/article.asp?issn=0028-
    3886;year=2011;volume=59;issue=4;spage=601;epage=604;aulast=Krishnan

    1. What happen to the case?

    The patient underwent a right frontoparietal craniotomy and vertical parasagittal


    functional hemispherectomy as described by Delalande. Postoperatively, the patient
    did not have any worsening of his pre-existing deficits and has been seizure free for
    more than a year. Post hemispherectomy re-organization begins soon after surgery but
    can continue for as long as 1 year. Our patient presented with mild left-sided
    weakness with intact gross motor and fine motor activity much later than the
    stipulated time for plasticity capacity. Such patients are known to be more susceptible
    to have significant postoperative weakness. An fMRI, however, showed a complete
    shift of the motor function to normal hemisphere. This precluded his chances of
    postoperative deterioration. Our patient had a clear functional shift to the normal
    hemisphere seen on fMRI; probably this may explain his good motor outcome.

    2. Declare the signs and symptoms


     Intractable seizures since the age of 8 months.
     He had infantile spasms at the onset and used to have disabling multiple
    seizure types: Left focal seizures with secondary generalization, sudden head
    and trunk flexion associated with falls and injuries, and atonic seizures since
    the age of 2 years.
     The preoperative seizure frequency was two to three times per week, mostly
    in clusters at any time of the day.
     He had delayed motor milestones and attained walking at 2 years and
    language at 3 years.
     Left hemiparesis was noted at 2 years of age.
    3. How was the family affected by what happen or who was affected?
    It was the 21 year old male, other than that there was none specified.
    4. What kind of treatment was given?

    Functional MRI (fMRI) was conducted. Several techniques such as


    intracarotidamobarbital test (Wada test), Functional hemispherectomy, positron
    emission tomography, diffusion tensor imaging (DTI), transcranial magnetic
    stimulation (TMS) and near infrared spectroscopy have been used to assess such
    shifts in individual patients. Among these, fMRI is the most popular, considering its
    wider availability and non-invasive nature. Till the results of careful longitudinal
    studies in patients with well-defined lesions and specific deficits are available, results
    of fMRI should be interpreted in light of other studies. Specifically, a combination of
    fMRI information with DTI fiber tracking or TMS may prove more accurate for this
    purpose.

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