Activation of the left motor cortex during left leg movements after right central resection

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 67; no. 4; pp. 487 - 491
• Main Authors: Wieser, H Gregor, Henke, Katharina, Zumsteg, Dominik, Taub, Ethan, Yonekawa, Yasuhiro, Buck, Alfred
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.10.1999; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Atrophy; Biological and medical sciences; Brain - diagnostic imaging; Brain - surgery; Convulsions & seizures; Encephalitis; Encephalitis - physiopathology; Female; Functional Laterality - physiology; functional plasticity; H2 15O PET; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; hemispherectomy; Humans; Leg - physiology; Medical sciences; Motor Cortex - diagnostic imaging; Motor Cortex - physiopathology; Movement - physiology; Nervous system (semeiology, syndromes); Neurology; Rasmussen’s encephalitis; Tomography, Emission-Computed; Radionuclide study; Human; Encephalitis; Nervous system diseases; Epilepsy; Exploration; Surgical resection; Cerebral disorder; Case study; Subintrant crisis; Surgery; Motor cortex; Central nervous system disease; Positron; Emission tomography
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.67.4.487

A patient with Rasmussen’s encephalitis underwent a right central resection at the age of 6 as a treatment for status epilepticus. She became seizure free, but suffered a left hemiplegia which improved so that she could walk. Because of the recurrence of seizures an enlargement of the resection to a hemispherectomy was carried out 17 years after the first operation. Various examinations, including H2 15O PET and amytal testing, performed before this second operation indicated that a compensatory reinforcement of the ipsilateral uncrossed corticospinal and spinocortical pathways had taken place. This was confirmed postoperatively. The patient had no new sensorimotor deficits.