Head shaved, a little boy rests on the operating table, deep under anesthesia. His parents have brought him to Boston Children’s Hospital in hopes of determining the cause of his seizures. Now, neurosurgeons Scellig Stone, MD, PhD, Joseph Madsen, MD, and their colleagues in the Epilepsy Center are performing a procedure designed to monitor seizure activity in the 3-year-old’s brain.
But as the team members crowd around the table, they’re not alone. With the push of a button, a large robotic arm rotates and lowers right next to the boy’s head, helping the physicians pinpoint the precise location to drill. “This is a real game-changer,” murmurs one of the clinicians observing the surgery. “It’s going to transform the way we practice.”
Enhancing minimally invasive seizure monitoring
For patients who don’t respond to anti-seizure drugs, surgery often holds the only hope for managing epilepsy. To identify the area of the brain from which seizures are originating, physicians have traditionally performed subdural intracranial seizure monitoring.
This invasive approach involves surgically opening the skull and placing a grid of electrodes on the surface of the brain. It’s a lengthy operation with a long recovery time, and it can’t always locate deep seizure origins.
Increasingly, neurosurgeons are relying on stereoelectroencephalography (SEEG), a procedure in which electrodes are instead fed on tiny wires through trajectories drilled into the skull. These electrodes can reach deeper into a child’s brain — and can present a better opportunity for clinicians to determine the source of seizure activity. Boston Children’s is currently a leading destination for pediatric SEEG in the United States.
“SEEG is far less invasive and far better tolerated in children,” says Stone. “There’s a night-and-day difference for patients in terms of recovery after surgery.”
Read the full post on Vector: Robot-enhanced neurosurgery for nimbler seizure mapping
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