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Long-term follow-up in children undergoing hemispherectomy for refractory epilepsy showed that most were seizure-free and able to walk independently, but deficits in many areas of daily function were common, researchers said.

Among 115 children with a mean of 6.05 years of follow-up, 70 were seizure-free and 96 were able to walk without assistance, according to Ajay Gupta, MD, of the Cleveland Clinic in Ohio, and colleagues.

But two-thirds of the children had at least mildly impaired speech, some 85% either required assistance at a mainstream school or were in a special school, and, among those 6 or older, only 18% had age-appropriate reading ability, the researchers reported online in the journal Epilepsia.

Poorer outcomes for walking, speech, reading, and behavior were significantly more common if seizures had recurred, Gupta and colleagues found.

Additionally, poor motor outcomes were significantly associated with abnormalities in the unoperated hemisphere as seen on an MRI (P<0.05) and preexisting quadriparesis (P<0.01), they reported.

In previous studies, hemispherectomy had been associated with seizure freedom rates of 52% to 80% and the procedure is considered "an effective treatment option for children with medically refractory epilepsy caused by extensive congenital or acquired hemispheric lesions," Gupta and colleagues wrote.

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