Teenager's epilepsy is 'cured'
thanks to robot that creates sat-nav of the brain and locates exact spot
triggering the seizures
A teenage boy has become one of the first people in Britain
to have his epilepsy cured by a robot which created a 'sat-nav' of his brain.
Billy Whitaker, 15, had suffered daily seizures for seven
years and conventional surgery to remove part of his brain had failed.
So neurosurgeons used a pioneering £350,000 robot to drill
electrodes deep into his brain.
They pinpointed the epicentre of his debilitating attacks
with absolute accuracy for the first time.
That enabled surgeons at Bristol Royal Hospital for Children
to access and remove the tiny piece of seizure-causing tissue. Since the ground-breaking operation two weeks ago Billy has
not had a fit and medics are confident he has been cured for good.
Consultant neurosurgeon Michael Carter said: 'There were
little parts of his brain we suspected were the candidates for causing these
residual seizures. 'We used the robot to implant a series of electrodes using
ultra-high, sub-millimetre precision, into these small areas of the brain, in
order to see if his seizures were coming from them. 'In fact we located the area absolutely beautifully using
one of the electrodes and, on the strength of that, we took him back to theatre
a week later and removed the area of brain tissue that was defined by the
examination.'
He added: 'We can use the robot to define extremely
safe and high precision trajectories through the brain tissue, so that we can
implant a number of electrodes through tiny little holes in the skull, with
little stab incisions, directly into the areas we want.
'We're hoping he's going to be seizure free for the future
He went on to
say the device 'represents a revolutionary transition into the 21st century for
epilepsy surgery ''.Billy, a keen
sportsman, had suffered with epilepsy since the age of eight with daily
seizures or 'auras' - pre-attack episodes which left him feeling dazed.
In 2014 surgeons
removed a section of his right temporal lobe removed, the area where it was
thought the abnormal electrical signals were being produced.
The seizures
stopped for around a year but Billy was devastated when they returned - and
they became harder to control with medication in recent months.
HOW DOCTORS CURED BILLY .
The procedure
under general anaesthetic saw doctors perform a number of scans to create a 3D
map of Billy's brain to identify the areas for 'interrogation', on January 14.
They then
screwed a frame into his head using four pencil-lead thick screws to guide the
robot to position the drill.
The robot
then provided a 3D trajectory of the place it was going to place the electrode,
and positioned the 1mm thick drill bit ready for the surgeon.
The high-tech
machine drilled through the skin and skull, and then 3cm into the brain tissue
in four difference locations, before then guiding in a silicon electrode.
When Billy
came round following the five-hour operation his epilepsy medication was
reduced to bring-on seizures - and he had nine attacks over three days.
The
electrodes - which were screwed onto his scalp - picked up the signals via the
sensors along their length, pinpointing the exact location in his brain causing
the attacks.
A week later,
Billy went back under the knife where surgeons cut a 'trap door' in his skull
and cut out the finger-tip sized bit of brain which was causing his fits. When Bristol
Royal Hospital for Children got its new Neuromates Robot, thanks to fundraising
by locals, doctors decided he would be their ideal first child patient.
The procedure
under general anaesthetic saw doctors perform a number of scans to create a 3D
map of Billy's brain to identify the areas for 'interrogation', on January 14.
They then
screwed a frame into his head using four pencil-lead thick screws to guide the
robot to position the drill. The robot
then provided a 3D trajectory of the place it was going to place the electrode,
and positioned the 1mm thick drill bit ready for the surgeon.
The high-tech
machine drilled through the skin and skull, and then 3cm into the brain tissue
in four difference locations, before then guiding in a silicon electrode.
When Billy
came round following the five-hour operation his epilepsy medication was
reduced to bring-on seizures - and he had nine attacks over three days.
The
electrodes - which were screwed onto his scalp - picked up the signals via the
sensors along their length, pinpointing the exact location in his brain causing
the attacks. A week later,
Billy went back under the knife where surgeons cut a 'trap door' in his skull
and cut out the finger-tip sized bit of brain which was causing his fits.
Only four
units in the UK have the machine - and Billy is the first child at the Bristol
hospital to have the operation - called robotic stereotactic EEG.
It is
understood it has been previously carried out at Great Ormond Street two or
three times.
Before this
procedure, electrodes were placed on the outside of the skull over a long
period of time, or couldn't be inserted in difficult to reach areas, or with
exact accuracy.
be inserted in difficult to reach areas, or with
exact accuracy.
The machine maps and moves to the chosen place where the
electrode will be placed, and guides the surgeon who makes the incision.
In the future the operation could be performed completely by
the robot - with a surgeon guiding it from 1,000 miles away. Billy, from Trequite, Cornwall, is still recovering in
hospital but is looking forward to getting back to school and playing sports
soon.
Speaking after the op on January 21 he said: 'Being seizure
free means I will be able to take part in sports like football and rugby again.
'I love playing sport and continue to play golf but since my
epilepsy diagnosis I can no longer play for teams as this often increases the
number of seizures I have.
'It is exciting to be the first patient to have been treated
at the hospital with this technique, especially as I and my family have
travelled all the way from Cornwall.
'Although it is sometimes boring being monitored, the care I
have received and the nurses who have treated me, have inspired me to look at
the potential of working for the NHS and in a hospital.'
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