Treatment of refractory epileptic adolescent with laser ablation instead of craniotomy

Epilepsy, a daily occurrence, afflicts children and their families

Iker was diagnosed with brain damage at 24 days old. At that time, doctors noticed that his head circumference had grown surprisingly fast, and through ultrasound examination, they found the cyst. Due to factors such as age, doctors recommend no intervention to maintain follow-up of cysts. After the brain damage was discovered, Iker was placed in early care and began special education at school age. At the age of seven, he began having absence episodes. As the disease progressed, Iker had episodes almost daily.

Absence seizure: A non-convulsive seizure that is clinically characterized by a sudden disturbance of consciousness, cessation of ongoing autonomous activities and speech, a blank stare with the eyes, a dull expression, and generally no fall. The seizure lasts for a few seconds to tens of seconds and then suddenly resumes, continuing the movement that was going on before the seizure. No postparoxysmal disturbance of consciousness. Patients often do not realize that they have experienced an attack, or only feel that there has been a "blank" moment in their mind. All episodes occur in the waking state. (Source Baidu Encyclopedia)

Until 2019, the Iker family lived in northeastern Spain, where the local hospital offered surgical treatment with craniotomy to remove epileptic lesions that did not respond to drugs. In 2019, with the family's job change, the family came to Barcelona, and Iker was transferred to SJD Barcelona Children's Hospital for treatment, where our doctors provided him with new options.

SJD Spain's first laser ablation of temporo-parietal occipital separation

Doctors introduce a laser probe into the seizure-affected area of the brain (which is larger and occupies the back quadrant) through a tiny incision in the patient's scalp, and then use the laser probe to isolate the part of the brain where the seizure took place. The whole operation is carried out with MRI, and the doctor can see the operation area in real time and with high precision, which can better ensure the accuracy and safety of the operation. At present, this laser ablation therapy is only suitable for children with refractory epilepsy whose focus is concentrated in the back quadrant of the brain.

◉ This is a less invasive and safer technique than craniotomy, allowing patients to recover in less time and be discharged home within 72 hours. The length of stay for craniotomy surgery was eight days. In addition, laser surgery is less invasive and causes less damage to the patient's appearance.