New Laser Surgery can help Children with Epilepsy

Removing part of a patient's brain is the traditional way to cure certain kinds of epilepsy, but the complications can be worse than the seizures themselves.

Now, there is a new high-tech and low-risk way to erase epilepsy. It is a medical first.

Robin and Khris Dysart say their son Keagan had gelastic seizures that sounded like laughter three times every hour.

A craniotomy was the best chance for a cure. Surgeons may have to take out normal brain tissue to move the lesion causing the seizures. Complications can include paralysis, uncontrolled urination, and death.

Keagan’s mother Robin says, "There were lists of children who have died."

Dr. Angus Wilfong adds, "You can't put back brain that you wish you hadn't taken out."

To avoid taking out any brain, Dr. Angus Wilfong and Dr. Daniel Curry of Texas Children's Hospital developed a low-risk, minimally invasive, MRI-guided laser surgery to cure epilepsy.

Keagan was one of their first patients.

The instrument used is smaller than the size of a pencil lead piece, according to Dr. Wilfong.

The doctors navigated their way to Keagan's deep-seated lesion.

With the MRI, they were able to see in real time exactly where they were in Keagan's brain. The doctors watched the laser destroy the lesion and cure Keagan's epilepsy.

"That's exactly what's happening and it's really amazing to see."

Today, Keagan is seizure free.

Robin says, "Now, the world has opened up to him."

He loves basketball and says, "I've been practice dribbling."

His life has been forever changed by a laser.

Texas Children's Hospital is the first in the world to perform the MRI-guided laser surgery to cure epilepsy.

The procedure was adopted from a technique to treat brain tumors.

It's now being used for kids and adults. The doctors tell us some of their patients go home the day after their brain surgery.

RESEARCH SUMMARY

BACKGROUND: Gelastic seizures are epileptic events characterized by bouts of laughter. Laughter-like vocalization is usually combined with facial contraction in the form of a smile. Gelastic epilepsy is very rare and occurs slightly more commonly in boys than in girls. Of every 1000 children with epilepsy, only one or at the very most, two children will have gelastic epilepsy. (SOURCE: www.epilepsyfoundation.org, www.ncbi.nlm.nih.gov/pubmedhealth)

The gelastic and other types of seizures are often very difficult to control. It is rare for anyone to have their seizures controlled for more than a few weeks or months at a time. The best outcome is probably seen in those children (and adults) who have a benign tumor in the hypothalamus (the hamartoma or astrocytoma) causing their epilepsy. Successful surgery in these children and adults may improve not just their seizure control but also improve their behavioral and even learning problems. (SOURCE: epilepsy.org.uk)

TREATMENT: The type of treatment prescribed will depend on several factors including the frequency and severity of the seizures as well as the person's age, overall health, and medical history. The majority of epileptic seizures are controlled through drug therapy. Patients may take a drug called anticonvulsants, to reduce the number of seizures they experience. Patients may also make changes to their diet. In certain cases in which medications and diet are not working, surgery may be used. (SOURCE: www.ncbi.nlm.nih.gov/pubmedhealth, www.webmd.com)

LATEST BREAKTHROUGHS: Real-time MRI-guided thermal imaging and laser technology is now being used to destroy lesions in the brain that cause epilepsy and uncontrollable seizures. The surgery is performed by first mapping the area of the brain where the lesion is located using magnetic resonance imaging. The catheter is inserted through the skull in the operating room and then the patient is transferred to an MRI unit where the ablation of the lesion is performed. The MRI confirms probe placement in the target, and the magnetic resonance thermal imaging allows the surgeon to see the ablation of the lesion by the laser heat as it happens with an automatic feedback system that shuts the laser off when the heat approaches nearby critical brain structures.

Read more here