She
started her presentation by stating some stark facts. You have a 60% chance of being seizure free
with your first medication. After that,
any other medication you try gives you only a 10% chance of seizure
freedom. Also, she said that success
rates are further decreased in today’s society because of family
situations. In 85% of all families with “special-needs”
children, the parents are divorced. As a
result, it is often difficult to get them to work together for the good of
their child. If that hurdle can be
overcome, decisions will not necessarily be easier, but more team based, so no
matter how difficult, it will be done together with no second guessing.
In the past, the go-to treatment has always been
medication first. However, this should
not be the way we think today. As Dr. Zupanc said,
you have to diagnose the condition first and then choose the appropriate
treatment. In many cases, surgery is a
first-line treatment. Children especially,
whose brains are elastic and adaptable, should take advantage of surgery if
they have really debilitating seizures.
After all, the more seizures they have, the more it will slow down their
development.
There
are the traditional surgeries of cutting out certain parts of the brain where
the seizure activity takes place, in any of the four lobes: temporal, frontal, parietal, occipital. Then, there is the hemispherectomy in which
an entire hemisphere is either taken out or neutralized. This is done mainly in children. I don’t think the average adult could imagine
him or herself functioning with only one half of his or her brain.
In
the pipeline they are working on (1) Deep Brain Stimulation which uses electrodes directly
placed on the brain, (2) Responsive Neurostimulation which focuses on targeted
areas of the brain before a seizure starts, (3) Gamma Knife Surgery which uses
radiation, and (4) Visualase laser surgery.
I
really appreciate those people who participate in these studies. I admire their courage in trying these
treatments in the experimental trial stages. I know some will benefit, but many
will not. Thank you for your
volunteering—it will make us all better in the end.
Deep Brain Stimulation (DBS)
Responsive
Neurostimulation (RNS)
Gamma Knife Surgery
Visualase
Laser Surgery
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