Wednesday, March 12, 2008

The Dilemma


I was reading some research today and ran across this succinct summary of the dilemma that many Rasmussen parents must resolve, including Kristi and I. Basically deciding whether or not to move forward with the removal of half of their child's cerebral cortex. Of course, we have made that decision, pending approval by the Hopkins Neurology and Neurosurgery team, but this sheds some light on that dilemma. This may be bordering on whining, but I think that we may be excused under these circumstances. This is an elective surgery, and the parents must make the decision. Elective in the sense that the parents have to make the final "GO" decision. Luckily this is an elective surgery that our insurance will pay for. The medical staff will not make the decision for you. - Cris

"The dilemma is whether to perform surgery early and risk inflicting greater motor, visual and language impairments from which there may be greater recovery at a young age, or to pursue other therapies and delay surgery until the disease produces similar motor and visual deficits to those which would be inflicted by surgery. However, during the delay there may be progressive impairment of language and intellect in addition to deterioration in motor and visual abilities, with reduced potential for recovery in the older patient. Often the severity of the epilepsy along with the social and behavioural problems encountered in these patients push one into surgery but, in most hemispherectomy series, it is these patients in whom the highest rate of increased impairment is reported and for whom periods of rehabilitation are required. This, however, is not a surprise; it is a predicted consequence not just of surgery, but of the natural history of the disorder." A. M. Devlin, J. H. Cross, W. Harkness, W. K. Chong, B. Harding, F. Vargha-Khadem and B. G. R. Neville

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