surinenglish

Malaga surgeons cure boy's epilepsy after carrying out unique operation

Guillermo Ibáñez, Pedro Serrano, Victoria Fernández and Luis Muñoz on Wednesday.
Guillermo Ibáñez, Pedro Serrano, Victoria Fernández and Luis Muñoz on Wednesday. / Ñito Salas
  • The problematic brain tumour was removed following a procedure which remodelled brain functions and enabled speech to be unaffected

The life of a 17-year-old boy has changed completely and for the better, thanks to an operation carried out at the Hospital Regional in Malaga to remove a tumour from the left hemisphere of his brain, which is where the language area is situated. The surgery, which was carried out while the patient was awake, removed the tumour which was causing him to have epileptic fits almost every day and stopped him leading a normal life. He also underwent a procedure to remodel cerebral functions, and can now speak normally because the language area of his brain has been moved from the left hemisphere to the right.

The operation was carried out last July by the neurosciences department, and this week they held a press conference to explain what they had done. Present were the head of neurology, Pedro Serrano; the coordinator of the neurophysiology service, Victoria Fernández; the head of adult neurosurgery, Guillermo Ibáñez and neuropsychologist, Luis Muñoz.

The tumour was diagnosed when the patient was seven years old; it was found to be the cause of his epilepsy. He underwent surgery, but it was not possible to remove the whole tumour because it was located very close to the language area and there was the risk that he would lose the faculty of speech. As time went by his epileptic crises continued, because the tumour started to grow again. The doctors didn't want to operate again at that time because the patient needs to be awake and that was not possible in the case of a child.

Ten years after the first operation, doctors spotted that the patient's brain was starting to move the language area from the left hemisphere to the right naturally, but very slowly, while the tumour was growing quickly. To avoid his ability to speak being permanently impaired, the doctors decided to apply direct electrical stimulation to the cerebral cortex to speed up the innate processes of neuronal plasticity which had already begun autonomously. Their objective was to move the language function from the left part of the brain to the right and, once that had been done, remove the tumour and cure the epilepsy.

The neurosurgeons carried out a craniotomy and placed a blanket of electrodes over the area of the lesion. Using cortical mapping they located the language function and applied an inhibitory cortical electrical stimulus to annul the function. At the same time, they carried out intensive rehabilitation of the language faculty, literally forcing it to use the area developed in the right hemisphere.

The language stimulation was carried out by Luis Muñoz, who set up a rehabilitation programme to encourage the activation of the contralateral areas (in the right hemisphere) so they took on the language function. The rehabilitation took place over a week, including the weekend, for three hours a day.

After seven days the patient was able to speak and understand, and the language area on the left side of the brain had been deactivated so it could function normally on the right. The next step was to operate to remove the tumour.

The operation was successful. The tumour was removed, the epilepsy stopped and the teenager was able to speak. This major success brings hope for other epileptic patients who are unable to have surgery at present for fear that it could cause damage in some areas of the brain.