Milestones in the Evolution of Hemispherectomy

Surgical treatment of hemispheric epilepsy has progressively evolved from anatomical hemispherectomy to functional hemispherectomy and more recently to hemispherotomy. These developments in the surgical technique have to a large extent avoided the complications associated with large brain excisions and at the same time maintained the excellent seizure outcome associated with the surgical treatment of hemispheric epilepsy. We review the evolution of the surgical procedures, indications for surgery and the surgical outcomes of hemispherotomy series published in literature to date.