Hemispherotomy can cause post-operative strabismus

• DOI: 10.1016/j.braindev.2019.08.011
• Publication Date: 2019-09-11T21:18:33Z
• Authors: Ayataka Fujimoto; Tohru Okanishi; Keishiro Sato; Shinji Itamura; Shimpei Baba; Naoki Ichikawa; Mitsuyo Nishimura; Kazuki Sakakura; Yosuke Masuda; Hideo Enoki
• Keywords: Strabismus Surgery

Hemispherotomy, which involves disconnecting hemispherical fibers, is a treatment option for medically intractable epilepsy. As various neurological disorders can cause strabismus, we hypothesized that hemispherotomy can cause post-operative strabismus in patients with medically intractable epilepsy.Nineteen patients underwent the Hirschberg test before and after hemispherical disconnection surgery. Among the 19 patients, 16 patients (six females and 10 males; mean age, 12.2 years; range, 0.17-43 years) who underwent hemispherotomy were included in this study.The difference in the angle between the left and right eyes was significantly widened (p = 0.025). Nine (56%) of 16 patients exhibited post-operative chronic strabismus as evaluated with the Hirschberg test. Intermittent strabismus was noticed by family members or caregivers in 10 (63%) of 16 patients. Patients older than 12 years did not show post-operative strabismus as evaluated by the Hirschberg test.Hemispherotomy can cause or worsen post-operative strabismus in pediatric patients.