What is hemispherectomy and which children need this rare surgery?

A hemispherectomy is a rare neurosurgical procedure where one half of the brain is removed or disconnected to treat severe, drug-resistant epilepsy. It’s performed on children whose seizures originate from one damaged hemisphere, allowing the healthy side to take over motor, speech, and cognitive functions over time. Candidates include children with Rasmussen’s encephalitis, hemimegalencephaly, large perinatal strokes, and Sturge-Weber syndrome. Two surgical approaches exist. Anatomical hemispherectomy removes the diseased hemisphere completely. Functional hemispherectomy disconnects it while leaving most tissue in place.

According to Dr. Gurneet Singh Sawhney, an accomplished neurosurgeon in Mumbai, When seizures destroy a child’s development and medications stop working, removing the damaged hemisphere often gives the healthy side a chance to take over functions, and that recovery still surprises me after years of doing this work.

Worried your child’s seizures aren’t responding to medicines anymore?

How does hemispherectomy actually work in the brain?

The procedure works on a simple principle. One half of the brain is causing relentless seizures, and removing or disconnecting it stops the electrical storm without crossing into the healthy side.

• Anatomical: The diseased hemisphere is surgically removed entirely, leaving only the brainstem, basal ganglia, and thalamus untouched on that side.
• Functional: Surgeons cut the connections instead of removing tissue, so the bad hemisphere stays in place but can’t communicate with anything else.
• Hemispherotomy: A modern variant that uses smaller openings to disconnect the hemisphere through targeted cuts, less blood loss and faster recovery.
• Plasticity: Younger brains rewire fast, and the healthy hemisphere often takes over speech, movement, and memory functions over months.

After surgery, most children walk again within weeks though weakness on the opposite side usually stays for life. For deeper context on related procedures, see epilepsy surgery in Mumbai.

Which children actually need hemispherectomy?

Not every child with epilepsy qualifies. The decision rests on damage being limited to one hemisphere and seizures being completely uncontrolled by medication.

Children showing daily drug-resistant seizures, hemiparesis on one side, and developmental regression need urgent evaluation. Detailed seizure workups guide candidacy, and parents can read more in this seizure surgery guide.

So the threshold is clear. Damage on one side, no response to medicines, and quality of life slipping away.

Why Choose Dr. Gurneet Singh Sawhney?

Dr. Gurneet Singh Sawhney brings 18+ years of neurosurgical experience with fellowships in Functional Neurosurgery and Epilepsy Surgery from Tokyo Women’s Medical University and Juntendo University, Japan. He stood 1st in MCh Neurosurgery at Rajiv Gandhi University and was ranked among the Top Neurosurgeons in Mumbai by India Today.

Children referred for hemispherectomy receive a complete pre-surgical workup, video EEG mapping, and a recovery plan built around regaining motor and speech function. Outcomes speak for themselves.