National Taiwan University Hospital (NTUH) yesterday said it has performed its first minimally invasive surgery of severing the nerves connecting the cerebral hemispheres.
The surgery was performed on a three-year-old girl with epilepsy, it said.
The girl, surnamed Weng (翁) started showing signs of abnormalities, such as sudden dullness and seizure on the right side of the body, at age two, said NTUH surgeon Yang Shih-hung (楊士弘), who treated the patient.
Weng was diagnosed with intractable epilepsy as a result of encephalitis, which was controlled by medication for a few months, but when she turned three old, she began to experience loss of consciousness, paralysis and frequent seizures, and required feeding through a nasogastric tube, he said.
After several medications proved ineffective, surgery was suggested, he added.
Yang discovered that her left cerebral hemisphere was nearly nonfunctional, but abnormal electrical discharges continued to affect the right hemisphere, causing seizures, he said, adding that traditionally, doctors would perform a hemispherectomy to remove the left cerebral hemisphere.
With the help of pediatric neurosurgeon Sandi Lam — who is also head of neurosurgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and had flown to Taiwan for the surgery on her vacation — the NTUH surgical team was able to complete a seven-hour, minimally invasive hemispherectomy by only cutting the corpus callosum, a bundle of nerve fibers that connect the hemispheres, Yang said.
In the procedure, they only made a 6cm incision on the scalp and did not remove any brain tissue, greatly reducing the risk of massive hemorrhaging or hydrocephalus, he said.
The surgery would leave Weng physically weak and blind in one eye, but as her left cerebral hemisphere was already nearly nonfunctional, which would have continued to damage the right hemisphere and might even lead to complete brain paralysis, the procedure was considered the best option, he said.
NTUH pediatric neurologist Fan Pi-chuan (范碧娟) said the chance of developing epilepsy occurs in 0.5 to 1 percent of people, and about 20 percent of them have intractable epilepsy, meaning the seizures cannot be controlled by medication.
These patients might consider discussing with doctors surgery to control the seizures and improve brain function and development, Fan said.
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