New method for Awake SURGERY on brain
If medicines do not help in the case of epilepsy, decide the Doctors for a surgical procedure on the brain: certain areas are removed, one of which is the massive nerve-cell discharges arise in the case of the epileptic seizures. Such an Operation must perform brain surgeons in part, to awake patients – a huge challenge for the Affected.
US scientists are now reporting of a particular case, the OP seemed to be not Awake-because of pronounced Fears of the patient to be possible. The 23-Year-old suffered from epileptic seizures, that drugs do not control. She was, therefore, at the Emory University School of Medicine (the U.S. state of Georgia) in the treatment. In addition, she suffered from a mild Depression and greater anxiety.
In order to localize the origin of epilepsy more precisely, implanted the Doctors of the patient electrodes below the skull bone to the brain, as they report in the “Journal of Clinical Investigation”. So they were able to observe for several weeks, the activity of your brain and record it.
“Just feels good”
During this monitoring, the physician was also stimulated with electrical pulses, the so-called belt winding (cingulate Gyrus) in the brain of the woman. This belongs to the limbic System for processing emotion responsible. In the brain of depressed patients, a modified activity is to be found in this Area often.
As the neurosurgeons in a particular part of the researchers caused the patient a relaxed, happy behavior. In a Video, you can see that the woman is able to frown or look serious, even when the doctors ask you to remember a sad Situation. She explains with a laugh: “It just feels good.”
The observed effect is brought to the physician an idea: they used the positive effect of the nerve stimulation to calm the patient in a two days later, Operation.
With such a procedure, the patient will first receive an anesthetic, so that you can hear from the Opening of the skull nothing. Then you Wake up from the anesthesia. Often this is a delicate Moment, because the patients get scared. “Even well-prepared patients can get during an awake operation in a panic, what can be dangerous,” said Neurosurgeon Kelly Bijanki, the main author of the study, according to a statement.
No Depression, anxiety
The 23-year-old epilepsy patient was restless and went to the awakening first in a panic: “When we carried out your cingulate Stimulation, she reported immediately that she felt happy and relaxed”, Bijanki. “She told jokes about her family, and was able to tolerate the awake procedure successfully.”
During the procedure, the Stimulation was interrupted, however, unintentionally: The patient became nervous and anxious and was close to tears. After the Doctors had done the Stimulation again,; your feelings of anxiety quickly, and your cheerfulness returned.
The Doctors were able to perform the surgery without further complications, and certain nerve cell to remove areas. At the end they took the electrodes. Six and twelve months after the procedure, it was not the patient well, she was depressed and her anxiety symptoms had decreased significantly.
Costs justify the Benefits?
After the successful attempt at the 23-Year-old, the Doctors repeated the procedure for two further patients, a 40-year-old man and a 28-year-old woman. In both cases, the Stimulation caused similar effects as in the first patient.
For Walter Stummer, Director of the clinic for neurosurgery at the University hospital of Münster and member of the management Board of the German society for neurosurgery (DGNC), the ndings are interesting. “However, I’m not sure whether the effort justifies the Benefit.” Because before the actual intervention, a further Operation was needed to place the electrode. “Overall, the risks of such an intervention are low,” says Stummer, who was not involved in the study. “It is special, however, requires knowledge and a large, multidisciplinary Team from neurosurgery, neurology and neuro-physiology.”
With less effort, the Stimulation of the belt turns from his point of view would actually be a helpful additional measure. For one, you could calm down particularly anxious patients. The very long guard operations would have to solve, in which the patient continuously, probably for this more bearable. Stummer says: “in view of the sophisticated methods we have, I am sceptical as to whether this will prevail.”
Note: In a previous Version of this article, we have the Emory University School of Medicine in the state of Atlanta is located. Atlanta is the capital of the U.S. state of Georgia, in which the University is located. We have corrected the error.