Alteration of Ipsilateral Cortical Activation during Passive Movement Rehabilitation in a Patient after Functional Hemispherectomy for Hemegaencephaly
Purpose] In this case study, using near-infrared spectroscopy (NIRS),we investigated the effect on cerebral cortex activity of passive motion of both upper limbs of a patient who had received functional left-side hemispherectomy for hemimegalencephaly, and considered the results together with the post-op. degree of recovery from paralysis. [Subject] The subject was a 6-month-old boy who showed convulsions at the age of 4 months. Since the effects of pharmacological treatments were limited and
... were limited and developmental regression was seen, functional left-side hemispherectomy was performed at the age of 6 months and rehabilitation was begun 4 days post-op. [Method] On post-op. days 10, 20 and 33 we investigated the changes in local and regional cerebral cortex blood flow using optical topography equipment for NIRS, examined development (Enjoji Infantile Development Test, upper limb movement items), and assessed movement function (volitional movement, muscle tone, and sensory examination). [Results] Through right upper limb passive motion and sensorimotor stimulus, the blood flow in the ipsilateral cerebral cortex primary sensory area sequentially increased, and recovery of motor development as well as motor function was confirmed. [Conclusion] When there is unilateral cerebral hemisphere disorder, functional compensation is ipsilaterally (side of cerebral disorder) generated in the descending motor tract, but similarly in the ascending sensory tract, ipsilateral afferent tract functional compensation occurs, indicating the importance of ipsilateral control.