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Brain Plasticity

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Illustrating the brain’s plasticity

From: Bolt, Martin. Instructor Resources for Myers “Psychology.” (4th

Lecture/Discussion Topic: Maranda Francisco and Hemispherectomy

On August 7, 1985; surgeons removed the entire left hemisphere of 4-year-old Maranda

Francisco's brain. The young girl had suffered from epilepsy caused by an extremely rare

disease called Rasmussen's encephalitis. While seizures had affected only her right side, she

was rapidly losing the ability to walk, talk, eat, and learn. She was on constant medication and

lived her life in brief intervals between convulsions. As often as 120 times a day, and sometimes

only three minutes apart, seizures made the right side of her body useless.

Since the surgery, Maranda has not suffered a single seizure. In kindergarten, she was

swimming and taking dancing lessons. In the 2 years following the surgery, she grew 9 inches,

learned to jump rope, and became a local celebrity. She talked normally, and her memory was

intact. She walked with a slight limp, although therapy helped to minimize it. "Over the long haul,

I'd anticipate she'll be able to live quite a norma1life, with a mild weakness on the right side,"

says Benjamin Carson, head of pediatric neurosurgery at Johns Hopkins University, who per- formed the operation.

After 10 hours in the operating room, Maranda woke up with the words, "I love you, Mommy

and Daddy." Maranda's speech had already migrated to the right side of her brain. Part of her

amazing recovery is attributed to the fact that her right hemisphere had already taken over many

of the functions of its deteriorating left-side counterpart. Maranda is not an isolated case. Brain

hemispherectomy has been performed successfully on others. In fact, Maranda, along with

seven other "hemis" and their families, have returned to Johns Hopkins Hospital for four days of

mutual support and testing.

In general, the effect of removal of one hemisphere is inversely related to the age of the

child at the time of surgery. If performed early enough, the surgery does not seem to cause

deficits in higher mental function in adulthood. Two different theoretical conclusions have been

drawn from this finding. One is that no shift from one hemisphere to the other has occurred

because lateralization of function is not present in early infancy. The other is that hemispheric

differences are present very early in life, but the young brain has the ability to reorganize itself

in the face of damage to specific regions. Recent studies of the abilities of persons with left and

right hemispherectomies suggest that the latter plasticity explanation is more likely to be correct.

Hemispherectomy dates back to 1928 when it was devised as a treatment for malignant

brain tumors. It was unsuccessful. "Not only did it not cure, but there was great mortality (death)

and morbidity (illness) associated with it," reports Carson. The surgery was used again in the

1940s and 1960s as a treatment for seizure disorders, but each time it fell into disfavor because

of postoperative complications. A number of medical advancements have contributed to its

present success. Nevertheless, certain drawbacks may always remain. For example, some

neurological functions do not transfer from one hemisphere to the other. All the "hemis" remain

blind in one-half of each eye. They also continue to have some degree of paralysis on one

side of their bodies. Fine motor movement is lost in one hand. No dramatic changes occur

in personality, with one exception: The children are happier. Jason Brandt, Johns Hopkins

neuropsychologist, concludes: "That a child with half a brain can indeed be a whole person,

speaks to the malleability of both the human brain and human spirit. It's amazing, it's wonderful.

I'm at a loss to describe it."

Shulins, N. (1987, September 20). Mind mystery. Grand Rapids Press Wonderland, pp. 40-41.

Springer, S., & Deutsch, G. (1993). Left brain, right brain (4th ed.). New York: Freeman.

AP Psych Module 4; Maranda – Hemispherectomy.doc

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