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Intractable Seizures Can Be Handled By A Three-Stage Brain Operation, Neurosurgeon

ading so quickly that by the time the electrodes pick up the abnormal nerve firings, it is no longer possible to determine where they originated. Other noninvasive imaging techniques cannot accurately pinpoint where seizures begin.

To overcome this problem, neurosurgeons place electrodes directly on the brain itself, which requires removing a portion of the bony cranium and cutting through the dura mater, the tough fibrous tissue covering the brain. The implanted grid of electrodes, attached to an EEG machine, is used to continuously monitor seizure activity over several days, providing a map for the surgeon to the location where the seizures arise. In the second operation, the surgeon removes the seizure-causing tissue in the brain.

Dr. Weiner takes the operation one step further. He places another set of electrodes in the brain after the second operation in order to locate any other areas that may be causing seizures. So children are again monitored with a grid of electrodes over a period of days, and then undergo a third operation to remove any tissue that still may be causing seizures.

Despite the promising results so far, Dr. Weiner says that it hasn’t yet been demonstrated that there is a ‘direct correlation between freedom from seizures and developmental normalcy.’ However, he adds, ‘it is important to treat children as early as possible because persistent seizures are associated with a host of serious learning and developmental problems.’

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