Featured Research

from universities, journals, and other organizations

Innovative Surgical Technique Gives Hope To Patients Suffering From Refractory Epilepsy

Date:
June 19, 2009
Source:
Université de Montréal Hospital Centre
Summary:
Clinicians have perfected an operation, which was previously considered too dangerous, to control refractory insular epilepsy, using an innovative microsurgery technique. According to a recent study, the new surgical technique is both safe and beneficial for patients.

Clinicians from the Centre hospitalier de l'Université de Montréal (CHUM) have perfected an operation, which was previously considered too dangerous, to control refractory insular epilepsy, using an innovative microsurgery technique. According to a study published as the feature article in the latest issue of the Journal of Neurosurgery, the new surgical technique is both safe and beneficial for patients.

"Recent observations by our team and others confirm the previously unsuspected role played by the insula in cases of refractory epilepsy. The non-recognition of insular seizures has probably been responsible for some failures in epilepsy surgery in the past," note doctors Alain Bouthillier, neurosurgeon, and Dang Khoa Nguyen, neurologist, the study's principal investigators, who teach at Université de Montréal and are researchers at the CHUM's research centre.

For many years, insular surgery to treat refractory epilepsy was abandoned and it is still rarely practiced because of the risk of damaging important structures of the brain. Initial attempts to resect the insula resulted in a high rate of complications, including hemiparesis (partial paralysis) and dysphasia (language loss). However, better understanding of the anatomy of the brain, in particular, the cerebral cortex and its vascular system, combined with the use of microsurgical techniques, now enable surgery to be performed on the insula, with greatly reduced risk to the patient. "This is the first cohort of patients with refractory epilepsy to have undergone such a procedure since the work of neurosurgeon Wilder Penfield in the 1950s," adds one of the investigators, Dr. Ramez Malak, neurosurgical resident.

Methodology

A retrospective study over the past ten years evaluated cases of patients with refractory epilepsy who had undergone insular surgery. In order to confirm the epileptic foci, intracranial electrodes were implanted, with the surgeon using neuronavigation and magnetic resonance imaging of the brain. Insulectomy was performed either

  • as part of an insulooperculectomy, in which the insula and the opercula (meaning "lids": the lips of the deep fold that separates the frontal, temporal and parietal lobes) are completely removed;
  • by resection of the temporal lobe with insulectomy;
  • or as a pure insulectomy.

Results

Nine patients were treated successfully with insular surgery, seven for refractory epilepsy without tumour and two with refractory epilepsy associated with the presence of tumours. After surgery, some patients presented with transient complications (hemiparesis, dysphasia), which disappeared after a few days or weeks post-surgery.

One patient, who had suffered from regular epileptic seizures, despite numerous essays with a variety of anticonvulsants, has had no seizures since surgery and no complications. She was also able to stop taking anticonvulsants.

The role of the insula

The insula is one of the lobes of the brain. Its role is still not well understood but its multiple connections with other parts of the brain reflect its involvement in a wide range of functions: automatic, sensory, motor, speech, auditory, olfactory, gustatory and limbic (emotion).

The CHUM epilepsy multidisciplinary team

The epilepsy multidisciplinary team is one of the principal groups of clinicians and professionals in Quebec treating people suffering from epilepsy. This unit is a centre of excellence, where services to its clientele and fundamental and clinical research and teaching activities are concentrated. Providing tertiary and quaternary services, the members of the CHUM epilepsy multidisciplinary team work in conjunction with partners in the health network to provide their patients with continuity of care.


Story Source:

The above story is based on materials provided by Université de Montréal Hospital Centre. Note: Materials may be edited for content and length.


Journal Reference:

  1. Ramez Malak, Alain Bouthillier, Lionel Carmant, Patrick Cossette, Normand Giard, Jean-Marc Saint-Hilaire, Dong Bach Nguyen, and Dang Khoa Nguyen. Microsurgery of epileptic foci in the insular region. Journal of Neurosurgery, 2009; 110 (6): 1153 DOI: 10.3171/2009.1.JNS08807

Cite This Page:

Université de Montréal Hospital Centre. "Innovative Surgical Technique Gives Hope To Patients Suffering From Refractory Epilepsy." ScienceDaily. ScienceDaily, 19 June 2009. <www.sciencedaily.com/releases/2009/06/090610124631.htm>.
Université de Montréal Hospital Centre. (2009, June 19). Innovative Surgical Technique Gives Hope To Patients Suffering From Refractory Epilepsy. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2009/06/090610124631.htm
Université de Montréal Hospital Centre. "Innovative Surgical Technique Gives Hope To Patients Suffering From Refractory Epilepsy." ScienceDaily. www.sciencedaily.com/releases/2009/06/090610124631.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) — Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) — The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) — A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) — All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins