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Learn about hemispherectomy, when it is indicated and how it works to treat seizures.

Below, find frequently asked questions about hemispherectomy.

What is hemispherectomy?


What is the history of hemispherectomy?



What patients are appropriate for a hemispherectomy?


  • Medically intractable epilepsy with seizures arising from the pathological side.
  • Developmental retardation or arrest of maturation due to intractable seizures.


What are the various types of hemispherectomy?


Figure 1: Right Anatomic Hemispherectomy

A. Coronal MRI at level of anterior frontal lobe.

B. Coronal MRI at level of brainstem.

C. Sagittal MRI demonstrating removal of right hemisphere.

Figure 2: Left Functional Hemispherectomy

A. Coronal MRI demonstrating central resection and temporal lobectomy.


How long is the hospital stay after hemispherectomy?

After epilepsy surgery, children will spend 2-3 days in the pediatric intensive care unit (PICU) for close monitoring of their neurological status. Antiepileptic medications are continued at previous doses. Antiepileptic drug levels in the blood for some anti-epileptics, like carbamazepine and oxcarbazepine, are monitored during this period because of the drug interaction with anesthesia. An MRI is performed on the first postoperative morning to assess the brain after resection. Once the surgical drains are removed, the patient will be transferred to a regular pediatric nursing floor. PT, OT and speech therapy will be consulted based on the child’s needs. An average hospital stay slightly varies between patient to patient and usually ranges from 5 to 7 days. Length of stay decisions are made by the surgical team and are based on the child’s condition and recovery.

What happens after being discharged from hemispherectomy?

Upon discharge, rehabilitation services are often required to enhance recovery from a hemispherectomy. If medically indicated, the child may be transferred to a rehab facility for intensive physical, occupational and speech therapy. This is usually followed by home or outpatient services. If inpatient rehabilitation is not required, home or outpatient therapy visits are often indicated. Outpatient therapy can be provided through hospitals and free-standing facilities and schools. Parents should check with individual school systems to see if this is a service provided.

What complications are possible following hemispherectomy?
  • Most children have excellent long-term results following hemispherectomy with no unexpected adverse outcomes. Occasionally, however, some complications may occur.
  • Early complications, which occur either during the intraoperative or immediate postoperative period include intraoperative blood loss, electrolyte changes, hypothermia and aseptic meningitis.
  • Late onset complications can occur months or years after the hemispherectomy. These hydrocephalus and recurrence of seizures, though rare, can be life threatening and need to be treated urgently.

Treatment Outcomes

Access success rates for patients at Cleveland Clinic following hemispherectomy surgery.



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