* QF entity performs complex epilepsy surgery for first time on an international patient
Sidra Medicine, a Qatar Foundation (QF) entity, has performed a complex epilepsy surgery for the first time on an international patient.
Salem is a 10-year-old boy from Kuwait who used to suffer from at least 15-30 seizures a day. Each seizure could last from a few seconds to up to four minutes, increasing the danger to his physical health.
Salem was transferred to Sidra Medicine in Qatar, after his family in Kuwait sought a second expert opinion with the hospital’s renowned specialist treatment programme for children with intractable epilepsy.
Salem’s father, Dr Abdulrahman Abdullah, said: “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. And 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.”
“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 continued.
Dr Husam Kayyali, acting division chief of Neurology at Sidra Medicine, said: “Salem’s case was brought to our attention when his father reached out to our international office about saving his son’s life. 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. 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.”
Salem was cared for at Sidra Medicine by a multidisciplinary team of experts from neurology, neurophysiology, radiology, nuclear medicine, neuro-psychology and neurosurgery. He was also extensively supported by a wider team from occupational health, physical therapy, rehabilitative medicine and ophthalmology to ensure a comprehensive pre- and post-operative care programme, a press statement noted.
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 statement points out.
“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. 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,” Dr Kayyali explained.
After completing the evaluation of Salem’s seizures, Dr Kayyali and his team consulted with Sidra Medicine’s neurosurgeons, Dr Ian Pople, division chief - Neurosurgery, and Dr Khalid al-Kharazi, and it was decided that Salem would benefit from a left hemispherotomy; an advanced and innovative technique that has proven to reduce the complication rates while maintaining good seizure control.
Dr Pople is one of the handful of neurosurgeons globally to specialise in the procedure in children and, together with Dr Kharazi, has performed several groundbreaking life-saving neurosurgeries on children in Qatar, including on international patients.
Dr Pople said, “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.”
Salem underwent an MRI on the same day as his surgery. The MRI helped the surgeons determine that the parts within the left side of his brain, which were causing his seizures, are now disconnected.
Salem was then transferred to Sidra Medicine’s paediatric ICU ward and stayed for a further three weeks, where he underwent physical and occupational therapy. During this time, the medical team were pleased to observe that Salem did not experience any epileptic seizures. He will continue to receive customised care back home in Kuwait, with physicians at Sidra Medicine coordinating his care with a team in Kuwait.
Salem’s father, Dr Abdullah, added: “As a physician myself, I was well aware of the complexities of my son’s case and am very impressed with the level of care, professionalism and the team-based approach that Sidra Medicine applied in my son’s treatment. This is very reassuring for families within the Gulf region, many of whom have to think twice about relocating for months on end to the US, UK or Europe for such complex surgery. I would like to specifically thank Dr Husam Kayyali and Dr Ian Pople. It is a blessing to have such pioneering experts so close to home.
Prof Ziyad M Hijazi, acting chief medical officer at Sidra Medicine, said: “I am very proud of our team-based approach, right from the co-ordination by our international office to our neurology, neurophysiology, radiology and neurosurgery team's approach in ensuring that Salem received the highest standards of care possible. This is testament to our world-class level of skills and expertise and that we are committed to offering the best paediatric services in the region and beyond.
"Sidra Medicine has a very strong co-ordination programme to help with paediatric cases from Kuwait and this year alone we have taken care of more than 40 patients from the country.”
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