Sidra Medicine saves young boy's life with complex epilepsy surgery

The young boy, Salem, from Kuwait used to suffer 15-30 seizures a day.

A team of medical professions at Sidra Medicine has successfully performed a hemispherotomy for the first time on a young patient.

Salem, the 10-year-old Kuwaiti patient, underwent the operation in a bid to put an end to his daily suffering which involved 15-30 seizures, some of them lasting for up to four minutes. Such seizures pose a severe threat to a patient’s physical and mental health.

“Due to the nature of Salem’s epilepsy, we had to have someone monitoring him all the time as he would have an uncontrollable seizure any minute, with the added risk of hurting himself,” said Abdulrahman Abdullah, Salem’s father.

“While he was on a good therapy programme, including anti-epileptic medications, in Kuwait, we had reached a stage where he was no longer responding to conventional treatment or medication.”

Hemispherotomy is a surgery that disconnects the cortex (or outer layer) of one half of the brain (or hemisphere) from the other without removing it.

The procedure prevents the spread of seizures from the dysfunctional hemisphere to the functional hemisphere.

Salem’s father, who is a doctor, sought a second expert opinion with Sidra’s renowned specialist treatment programme for children with intractable epilepsy before transferring his son to the hospital in Qatar.

“Our decision to bring my son Salem to Sidra Medicine was based on several recommendations within the international and regional pediatric medical faculty. The specialist and advanced therapies that Sidra Medicine offers competes with centres of excellence that are in the US or Europe. My family and I are extremely impressed with the care our son received here,” Salem’s father added.

In order to provide the best medical service and ensure Salem’s safety, he was immediately cared for upon arrival at the hospital by a multidisciplinary team of experts from neurology, neurophysiology, radiology, nuclear medicine, neuropsychology, and neurosurgery.

Salem was also supported by a wider team from various other medical fields to ensure a comprehensive pre-and post-operative care programme, according to Sidra Medicine.

“Intractable epilepsy can be a heavy burden, especially on children as they need constant monitoring and care. Studies have shown that only 3-4% of patients with intractable epilepsy would respond to treatment with antiepileptic medications,” said Dr. r Husam Kayyali, acting division chief of Neurology at Sidra Medicine.

“Cutting-edge advanced therapies such as epilepsy surgery might be the only answer in such cases. After a thorough evaluation of Salem’s case at Sidra Medicine, we decided to proceed with epilepsy surgery.”

Sidra Medicine is “one of very few children’s hospitals in the Middle East to have dedicated paediatric experts overseeing the entire spectrum of care for children with complex diseases or health challenges, including epilepsy,” the hospital said in a statement.

“Salem’s treatment programme at Sidra Medicine started with a thorough assessment and investigations at the Epilepsy Monitoring Unit with Video-Electroencephalographic monitoring and advanced neuroimaging such as high-resolution Brain MRI imaging and (positron emission tomography) PET scans,” Dr. Kayyali said.

“It was determined that Salem had suffered a stroke when he was a fetus inside his mother. This explained how he started getting refractory epileptic seizures when he turned five, which had progressively damaged the left side of his brain,” he explained.

After several consultations with specialists from Sidra Medicine, the doctors performed a left hemispherotomy, an advanced and innovative technique that has proven to reduce the complication rates while maintaining good seizure control.

“Hemispherotomy is quite a complex procedure and Salem’s case was our first on an international patient. We performed the surgery in our advanced high-tech neuro-imaging operating theatre, whereby we disconnected the left side of Salem’s brain from the right side. We then removed the affected part of his brain, which was causing the seizures, through the guidance of special MRI scans in the operating theatre,” said Dr Ian Pople, division chief – Neurosurgery.

After the procedure, young Salem was then transferred to Sidra Medicine’s paediatric ICU ward and stayed for roughly three weeks, where he underwent physical and occupational therapy.

Fortunately, during this time, Salem did not experience any epileptic seizures, highlighting the success of the surgery. To ensure his safety and well-being, Salem will continue to receive customised care in Kuwait, with physicians at Sidra Medicine coordinating with a team in the young boy’s home country.

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