Nahum, AS;
Liégeois, FJ;
(2020)
Language after childhood hemispherectomy: A systematic review.
Neurology
, 95
(23)
pp. 1043-1056.
10.1212/WNL.0000000000011073.
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Abstract
OBJECTIVE: To conduct a systematic review on language outcomes after left and right hemispherectomy in childhood, a surgical procedure that involves removing or disconnecting a cerebral hemisphere. METHODS: We searched MEDLINE, Embase and PsycInfo for articles published between January 1, 1988 and May 16, 2019. We included: (1) all types of observational studies; (2) studies where hemispherectomy was carried out before age 18 and; (3) studies with standardised scores measuring receptive vocabulary, expressive vocabulary, sentence comprehension, and/or sentence production. We calculated mean z-scores after left and right hemispherectomy in the whole group and within aetiology-specific subgroups. RESULTS: Our search identified 1,096 studies, of which 17 were eligible. The cohort added up to 205 individuals (62% left hemispherectomy) assessed 1 to 15 years after surgery. In the left surgery group, all language skills were impaired (z scores <-1.5) except sentence comprehension. In the right surgery group, language performance was in the borderline range (z scores ∼ -1.5). Children with cortical dysplasia showed the worst outcomes irrespective of surgery side (z scores <-2.5). Individuals with left vascular aetiology and right-sided Rasmussen Syndrome showed the best outcomes. CONCLUSION: Evidence based on the largest patient cohort to date (205 participants) suggests that the risk of language impairment after hemispherectomy is high, with few exceptions. Aetiology plays a major role in post-surgical plasticity. We recommend specialist evaluation of language skills soon after surgery to identify intervention targets. Large scale studies examining outcomes in consecutive cases are still needed.
| Type: | Article |
|---|---|
| Title: | Language after childhood hemispherectomy: A systematic review |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1212/WNL.0000000000011073 |
| Publisher version: | https://doi.org/10.1212/WNL.0000000000011073 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Aphasia, Neuropsychological assessment, Epilepsy surgery |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10114317 |
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