[Samuel Ford]

I’ve cared for a number of individuals who had suffered from a severe stroke / brain injury when they were young (some of whom then suffered from epilepsy afterwards – but in all cases this was more or less controlled by medication and wasn’t as severe as those who might require hemispherectomy).

In my experience these individuals can be profoundly disabled; one man I worked with was in his fifties but was mentally very childlike, required assistance in every basic aspect of living (washing, eating, travelling), he could speak but his vocabulary was extremely limited and repetitive. He did not understand much that you told him, any instructions needed to be broken down to extremley simple components. He had difficulty walking and could not use his left arm, difficulty with emotional regulation…etc (I’m not trying to diminish this person, I actually really got on with him and enjoyed caring for him.)

In table 3 some gross deficits are recorded before the operation – essentially could they walk, talk and did they have fine motor control (and it looks as if many of them couldn’t). This is not enough to see how these brain injuries/epilepsy have affected the person, I suspect from my own limited experience, and simply from the fact that this surgery is being performed at all, that these people were profoundly disabled to begin with.

Also I think what you said about the tests not being sophisticated enough is true, to be honest I don’t know how any test could fully capture somebody’s personality and individual, particular deficits – you would simply have to meet the people!