Doctors from the Department of Neurosurgery, Da Nang Hospital have just performed surgery to completely remove the lesion causing epileptic seizures in a 19-year-old female patient.
3 years ago, patient Luong THN (born 2004, residing in Trieu Phong district, Quang Tri province) started having episodes of losing consciousness about 2-3 times a week. Neither the patient nor his family thought it was epilepsy. The family thought the patient was possessed by a demon, so they invited a shaman, but of course the condition did not improve.
The patient often has seizures while awake, the sudden seizures have been dangerous for the patient, once causing the patient to have a traffic accident. Most recently, 3 months ago, the patient had a generalized seizure, was admitted to Da Nang Mental Hospital, diagnosed with epilepsy and given medication.
After that, the patient returned to his hometown and went to Hue Central Hospital for examination. Through MRI scan, a left temporal lesion was detected, sleep electroencephalogram was measured, and left internal temporal epilepsy was diagnosed due to this lesion, so he was referred to Da Nang Hospital for treatment.
At Da Nang Hospital, through clinical examination and MRI results, video EEG, and sleep EEG, it was found that this was a case of temporal epileptic lesion that could be operated on early, without having to wait for the conditions for drug-resistant epilepsy to be met for surgery.
The patient was evaluated before surgery with the coordination of neurology, neurosurgery, diagnostic imaging, anesthesia and resuscitation specialists, neuropsychological assessment tests and memory tests, and consultation with epilepsy surgery experts from Thailand, neurologists at Hue Central Hospital, the team agreed on a surgical plan to selectively remove the lesion and the amygdala and preserve other functional brain areas for the patient.
With modern equipment at the hospital supporting the surgery such as: intraoperative neural navigation system (Navigation), intraoperative neural monitoring (IOM), ultrasonic aspirator (Cusa) and initial surface electroencephalogram measurement during surgery, after more than 3 hours of surgery, the doctors of the Department of Neurosurgery, Da Nang Hospital completely removed the damaged area causing the epileptic seizure, preserving the patient's functional brain areas.
Currently, the patient is awake, has no seizures, no postoperative neurological deficits, and continues to be monitored according to the epilepsy patient management program.
Dr. Tra Tan Hoanh, Head of the Department of Neurosurgery, Da Nang Hospital, said that because the tumor located in the middle temple has a complex structure, surrounded by many blood vessels and important functional brain areas, it is difficult to remove all the damage while preserving the surrounding structures. However, with the smooth coordination between the doctors of the Department of Anesthesia and Resuscitation and the Department of Neurosurgery, along with the meticulousness and experience of the surgical team, the doctors successfully operated on the patient.
According to Dr. Hoanh, epilepsy is the second most common neuropsychiatric disorder. Patients are treated with anti-epileptic drugs, but more than 30% of patients are resistant to the drugs. Epilepsy surgery is one of the options that can completely treat or alleviate epilepsy for patients.
“This is a case of an epileptic patient with a temporal lesion causing epilepsy that was thoroughly and systematically evaluated before surgery with the coordination of many specialists, and at the same time, there were opinions from Thai experts contributing to choosing the best surgical option for the patient,” Dr. Hoanh added.
Da Nang Hospital has implemented routine EEG for epileptic patients, video EEG, sleep EEG to help diagnose, treat epileptic patients and pre-operative assessment to serve the treatment of epilepsy effectively and in accordance with the standards of the World Epilepsy Federation. The progress in implementing this technique will bring epileptic patients a new, safe treatment option that can completely treat epilepsy or reduce the frequency of seizures, as well as dependence on anti-epileptic drugs, improving the quality of life for epileptic patients.
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