The formerly conjoined twins separated in a lengthy surgery this week have opened their eyes and have begun moving, one of their doctors said Thursday.
The 1-year-old Guatemalan girls, Maria de Jesus Quiej Alvarez and sister Maria Teresa, remained in critical condition but stable condition at the University of California, Los Angeles Medical Center, said Dr. Andy Madikians.
"They both have opened their eyes," he told a 5 p.m. press conference.
"They are able to move a little bit. ... Maria Teresa is not moving as much," he said.
The difference between the amount of movement may have something to do with the fact that Maria Teresa underwent a second surgery, he said.
Developments in their recovery began early Thursday when doctors reported that Maria de Jesus fluttered her eyes after the girls were taken off paralyzing drugs administered after surgery to prevent coughing or movement that might injure their brains.
The parents of twins who had been joined at the head gave thanks to God and to the doctors who separated them — even if the girls were a little difficult to recognize.
The twins "look so much better" but "right now we can't recognize them because they have all these bandages around their heads," the girls' father, Wenceslao Quiej Lopez, told reporters Wednesday.
The girls' father and their mother, Alba Leticia Alvarez, spoke publicly Wednesday for the first time since the twins were separated in the marathon operation that ended early Tuesday.
"We've been very happy ... especially because we learned everything was going well," the 21-year-old father said. "And we are grateful to the hospital. We don't know how we'll ever repay them, but somehow God will repay them."
Pediatric nurse Berta Acosta, who has been caring for Maria Teresa, said the girls were expected to remain heavily sedated and on ventilators for at least three days to allow brain swelling to subside.
"Both girls are at the same level of recovery now. They're right on track," said Acosta, who interpreted for the Spanish-speaking parents.
The girls were attached at the top of the skull and faced opposite directions. While the two shared bone and blood vessels, they had separate brains. Cases like theirs occur in fewer than one in 2.5 million live births.
The two still face follow-up surgeries to reconstruct their skulls.
Surgeons at UCLA's Mattel Children's Hospital had to separate the individual blood vessels the two shared and decide which belonged to each child. Rerouting the flow of blood to and from the brain of each child put both at risk for stroke, UCLA neurosurgeon Dr. Itzhak Fried said.
In Guatemala, Juliana Hernandez, the twins' 85-year-old great-grandmother, told local media that she wished she could hold them.
"I haven't seen them in a long time," Hernandez said. "I've just seen the papers and TV images of them, but at this moment I would love to have them here and hug them." Family members have described the girls as happy and curious, with distinct personalities — Maria Teresa the social one, Maria de Jesus the quiet one.
Surgeons around the world have performed cranial separations at least five other times in the past decade, UCLA experts said. At least two twins did not survive, a boy who died in 1993 after surgery performed in South Africa, and a girl who died in 1995 after surgery in Toronto.