Visual impairment is among the risks of resective surgery for treatment-refractory epilepsy. A recent study published in the Journal of Neuroscience, however, suggests that children’s brains can reorganize and adapt to retain visual perception and processing after removal of visual cortex, even when there are reductions in peripheral vision.
In this study, children who had undergone surgery for medication-resistant epilepsy were asked to complete visual-behavioral tasks while having functional MRI (fMRI). All children had experienced improvements in their epilepsy after surgery; parts of visual cortex had been removed in 6 children and 4 had reduced peripheral vision unilaterally.
Participants were able to complete facial recognition, object naming, reading, and pattern recognition tasks suggesting that the remaining visual cortex was able to compensate for missing regions in a way that is not usually seen in adults.
“It turns out that the residual cortex actually can support most of the visual functions we were looking at,” said Tina Liu, National Institute of Mental Health (NIMH), “Those visual functions—recognizing patterns, facial recognition, and object recognition—are really important to support daily interactions.”
“It’s possible that early surgical treatment for children with epilepsy might be what allows this remapping,” said Erez Freud, PhD, assistant professor, York University, Toronto, Canada, “although more research is needed to understand what drives this type of brain plasticity.”
Michelle L. Dougherty, MD, FAAN, FAES
Brian J. Williams, MD