Release date: 2017-12-14
Recently, the multidisciplinary experts of the Epilepsy Center of the Children's Hospital of Fudan University (National Children's Medical Center-Shanghai) successfully successfully cured a child by intracranial implantation of electrodes and second-stage surgical resection. Completely get rid of the troubles of epilepsy, and retain the function of the brain, bringing new hope for children with refractory epilepsy in China.
It is worth noting that before the treatment, the above-mentioned children had entered the stage of no surgical treatment with “uncontrolled medicine and negative imagingâ€.
Conservative statistics show that there are 8 million to 10 million epilepsy patients in China, the vast majority of which are children and adolescents. Children with epilepsy need long-term medication to control the disease, and about 20 to 25% of them are "children with refractory epilepsy", even if taking medicine, the condition is still uncontrollable. Professor Wang Yi, director of the epilepsy center of the Pediatric Hospital affiliated to Fudan University, pointed out that repeated epileptic seizures can damage the nervous system of children. For refractory epilepsy, surgical intervention should be performed as soon as possible. The effect of pediatric epilepsy surgery is often better than that of adults. The plasticity of the deposit can make the nerve tissue have more opportunities to form compensation, in order to maximize the recovery of brain function.
8-year-old boy was afflicted with epilepsy for 3 years
The 8-year-old Zhejiang boy clearly should enjoy a healthy and happy childhood like a child of the same age. However, at the age of 5, there was a sudden blink of an eye and fear, accompanied by consciousness, followed by limb twitching, which occurred on average 2-3 times a week.
Dad took the child to start a long journey of seeking medical treatment. He was diagnosed with epilepsy in Zhejiang and started taking anti-epileptic drugs. His condition improved slightly. However, after a few months, the same symptoms reappeared, and the increase in dose did not work. Dad took the children to seek medical treatment and added a new combination of anti-epileptic drugs, but the effect was still not good. Frequent episodes and taking a variety of drugs every day make the once smart and lively child feel inferior and irritable, but can only stop studying.
Holding the last hope, Ming Ming went to the Pediatric Hospital affiliated to Fudan University. Director of the Department of Neurology, Zhou Yuanfeng, judged that he was suffering from "refractory epilepsy." In the EEG monitoring unit of the epilepsy center of the Pediatric Hospital, the video EEG clearly recorded the changes in the symptoms and EEG changes at the onset of the episode, and the thin-layer magnetic resonance examination found no structural abnormalities. Under the guidance of experts at the epilepsy center, a PET-CT examination of positron emission tomography was performed, and the most advanced image fusion technique was used to image the magnetic resonance and PET-CT, and finally found suspicious in the brain. Epilepsy area.
There is still surgery opportunity for imaging negative
The multidisciplinary expert team of the epilepsy center discussed the decision to determine the epileptogenic zone in the intracranial implanted electrode and to measure the electrical stimulation of the cerebral cortex. In the treatment of epilepsy, the brain function of the patient was fully protected from damage, thus achieving radical cure. The effect of epilepsy.
Dr. Zhao Rui, a neurosurgeon at the Pediatric Hospital of Fudan University, used the minimally invasive method to implant 11 deep electrodes in the brain. Each electrode of about 1mm was assisted by the computer, not only avoiding all the blood vessels, but also accurately reaching the target. The area has an amazing accuracy of 0.3-0.5mm. With the help of the intracranial electrode, the doctor accurately found the culprit leading to the seizure, and performed a functional measurement on this part of the cerebral cortex, and accurately designed the surgical resection. After the second operation, the doctor not only completely removed the onset of epileptic seizures, but also retained the function of the brain. After the operation, I was completely rid of the seizures. I once laughed at the lively teenager and returned to the campus.
Most children with early surgery can be controlled
Wang Yi, director of the epilepsy center of the Pediatric Hospital affiliated to Fudan University, pointed out that epilepsy is a very common neurological disease. Patients with refractory epilepsy who cannot take control of the seizures or can not tolerate side effects of drugs need to seek surgical treatment. "The effect of pediatric epilepsy surgery is often better than that of adults. The damage of seizures to undeveloped brains is more serious than that of mature brains. Therefore, pediatric refractory epilepsy should be operated as soon as possible, using the remaining plasticity of the brain to make nerves Organizations have more opportunities to form compensation, in order to maximize the recovery of functionality."
The Pediatric Hospital affiliated to Fudan University has integrated the work of neurosurgery, internal medicine, imaging, rehabilitation psychology and other professional teams to take the lead in the surgical treatment of refractory epilepsy in children. At present, the epilepsy center of the Children's Hospital of Fudan University, preoperative evaluation, surgical treatment and postoperative follow-up of children with refractory epilepsy, more than 60 cases of annual surgery, including cerebral hemisphere disconnection, anterior temporal lobe and medial Structural resection, neuronavigation lesions (brain/multi-brain) resection/dissection, corpus callosum, stereotactic intracranial electrode implantation (SEEG), vagus nerve stimulator implantation Epilepsy surgery, the proportion of no seizures after surgery is up to 90%, greatly improving the clinical efficacy of refractory epilepsy.
Especially for patients with negative imaging, the hospital uses multimodal image fusion and stereotactic technology (SEEG) for invasive EEG monitoring to determine the epileptogenic focus, and then undergo second-stage surgical resection, under the premise of fully ensuring the curative effect The maximum degree of retention of brain function is achieved in the treatment of epilepsy patients who have not been able to treat surgery.
Source: Zhongqing Online
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