Epilepsy Care Gets Robotic Boost at UC San Diego Health

Neurosurgery is among the many most difficult branches of surgical procedure. The human mind, with its estimated 100 billion neurons and 100 trillion connections, is arguably essentially the most complicated organic construction recognized, and surgeons should typically function inside the slim confines of the mind, spinal wire and nervous system.

Typically it’s good to have one other set of “palms,” a ROSA by one other identify.

ROSA is brief for Robotic Stereotactic Help, and inside the Division of Neurosurgery at UC San Diego Well being, the modern know-how is at hand.

Of the various procedures wherein ROSA can help, it shines maybe brightest throughout stereotactic electroencephalography (sEEG), an intracranial monitoring process wherein 10 to twenty skinny electrodes (lower than 1 millimeter in diameter, concerning the thickness of a bank card) are inserted into the mind to exactly map the places from which epileptic seizures emanate.

Sharona Ben-Haim, MD, the UC San Diego Well being neurosurgeon who launched sEEG to the San Diego area 5 years in the past, calls the process “a lot sooner and safer now, and with the effectivity and accuracy that solely a robotic platform can present.”

Sage Magaña, 18, not too long ago underwent the ROSA-assisted process. Two years in the past, she was recognized with frontal lobe epilepsy, with a typical day interrupted by as much as 5 seizures lasting for as a lot as 5 minutes every. It could generally require weeks to totally get well from essentially the most extreme episodes.

“I get up after a seizure and I limp, I cry, it’s horrible,” stated Sage, who lives along with her mother and father in Vista. “I’ve ache in my head, my jaw and my tongue and cheeks from biting them. It’s taken all the things away from me. It has stopped my entire complete life.”

Due to her seizures, Sage dropped out of highschool after her sophomore 12 months. Driving is a distant reminiscence. Hers is just not the everyday lifetime of a youngster.

Sharona Ben-Haim, MD, neurosurgeon at UC San Diego Well being poses with Alexander Khalessi, MD, chair of the Division of Neurosurgery at UC San Diego Well being, and their new robotic assistant.

Solely a really particular kind of affected person is prone to obtain sEEG, somebody for whom mind surgical procedure has turn into a final resort attributable to drug-resistant epilepsy. Sage stated the seizure medicine she tried “labored considerably, however not sufficient,” and that almost all produced hostile uncomfortable side effects, reminiscent of making her really feel “crazy” and “offended after I’m not.”

Sage opted for surgical intervention on the advice of Ben-Haim and Jerry Shih, MD, director of the Epilepsy Heart at UC San Diego Neurological Institute, following a multidisciplinary convention about her case.

Primarily based on Sage’s MRI scan, Ben-Haim programmed into ROSA the place every electrode must be inserted, after which ROSA’s robotic arm pivoted to the exact positions for every insertion.

“Every of the electrodes is deliberate with nice accuracy to enter and terminate (finish) in a sure a part of the mind, and to map particular anatomical options alongside its trajectory,” stated Ben-Haim, the one neurosurgeon in San Diego County presently performing ROSA-assisted sEEG on adults. (Rady Kids’s Hospital-San Diego has a ROSA for pediatric instances.)

Leads from implanted electrodes report {the electrical} exercise inside Sage’s mind, affording her the distinctive expertise of seeing the onset of her seizures by way of spikes within the readout.

“The place the electrodes go could be very particular for every affected person, primarily based on a really intensive preoperative workup that we do.” (Earlier than the appearance of sEEG, neurosurgeons positioned grid, strip and depth electrodes for intracranial monitoring. These have been typically very sophisticated procedures.)

When she emerged from anesthesia following the sEEG process at Jacobs Medical Heart at UC San Diego Well being, Sage stated she “felt somewhat little bit of ache, but it surely was very bearable — particularly realizing that that is my likelihood to get my life again.”

The electrodes remained inside Sage’s mind for per week, mapping her seizures. The ensuing knowledge (nonetheless being analyzed) will assist decide the most effective therapy. This will embody laser-assisted ablation or resection within the area of the mind inflicting the seizures.

“I simply wish to simply cease the seizures,” Sage stated, in order that she will be able to pursue a traditional life and maybe a profession serving to others by means of their epilepsy journeys.

“I wish to be that individual for another person,” she stated.