Helping Epilepsy in Children
Minimally invasive technique is having promising results
Epilepsy specialists at Miami Children’s Hospital are the first in the Southeast--and the second in the nation-to offer minimally invasive laser surgery for children with seizures that don’t respond to anticonvulsant medications.
Approximately one in five children with epilepsy (totaling thousands of children a year) experience frequent seizures that don’t stop with medication. Miami Children’s Brain Institute has long been a leader in helping these children with medically resistant (or “intractable”) epilepsy. The Miami Children’s Hospital (MCH) program has been ranked among the top programs in the nation for pediatric neurology and neurosurgery by U.S. News and World Report.
Due to the hospital’s reputation and its case experience with more than 850 epilepsy surgeries, the manufacturer of a new image-guided laser technology approached Miami Children’s in 2010 to establish protocols for use of the new technology, called Visualase. The first patient at MCH was successfully operated on in May of 2011. Prior to laser surgery, the patient was experiencing one or two seizures per week. Since the procedure, she has been seizure free for nine months and has an excellent prognosis, according to Dr. Ian Miller, Director of Neuroinformatics at Miami Children’s Hospital, who is spearheading the Visualase initiative.
The Visualase system works by placing a laser probe at the surgical site using stereotactic, 3D-computer guidance in the operating room. The patient is then moved to the MRI scanner where the laser removes the target brain tissue using heat under continuous MRI monitoring. This allows a very precise region of tissue to be treated and minimizes risk of injury to other parts of the brain.
Doctors hope this method (as compared to traditional brain surgery for epilepsy) will allow a very small incision (so that very little hair needs to be removed), less postoperative pain, reduced risk of infection, faster recovery time and no need for removing portions of the skull, which reduces the chance of jaw problems later on.
To date, three patients have undergone the new treatment at Miami Children’s, including one child who came from out of state for the procedure. Among these children, the longest hospital stay was three days, compared with a seven to 10-day stay required for conventional surgery.
Dr. Miller expressed optimism about the technology. “This is one of the newest tools in our toolbox to help children with epilepsy. It is perfectly suited for small, well-defined lesions in the brain that cause seizure activity,” he noted. He observed that there are many causes of epilepsy in children and that “this therapy is a particularly good fit for conditions such as cortical dysplasia, hypothalamic hamartoma and tuberous sclerosis.” -This information provided courtesy of Miami Children's Hospital
Twelve year-old Jessie Fernandez undergoes the first Visualase procedure at Miami Children’s Hospital