Functional outcome after vertical parasagittal hemispherotomy in pediatric hemimegalencephaly: Insights from a single case

Background: Parasagittal vertical hemispherotomy (PSVH) is a surgical technique increasingly adopted in epilepsy centers worldwide, providing excellent seizure control in children with drug-resistant epilepsy (DRE) due to unilateral hemispheric abnormalities. Case Description: We report a case of a 5-year-old girl with DRE secondary to hemimegalencephaly and treated with PSVH. At 11 months postoperatively, the patient achieved complete seizure freedom without major complications. This successful case supports the effectiveness and safety of PSVH in managing DRE caused by unilateral hemispheric lesions and highlights the importance of early surgical intervention in this pediatric population. Conclusion: PSVH achieves reliable seizure control with reduced surgical morbidity and favorable functional outcomes in children with hemispheric epileptogenic disorders.