Evaluation of gross and fine motor functions in children with hemidecortication: Predictors of outcomes and timing of surgery

The purpose of this study is three-fold: First, to determine the levels of gross and fine motor functions in children before and after hemidecorticati on, using standardized measurement tools; second, to investigate if predict ors of these outcomes can be characterized; and third, to explore if both c linical measures and functional magnetic resonance imaging (MRI) potentiall y can identify optimal timing of surgery. The Gross Motor Function Measure and the Quality of Upper Extremity Skills Test are shown to be comprehensiv e, standardized outcome measures of movement performance in affected childr en. Age at surgery and interval between age at seizure onset and age at sur gery could be the most reliable predictors of clinical outcomes. Functional MRI studies are valuable in exploring the potential of the cortical reorga nization that sustains residual sensorimotor function. The combination of c linical measures with functional MRI is a promising method of inquiry into developmental and plasticity processes.