Selasa, 01 Mei 2012

Treatment of Children's Epilepsy by Hyperbaric Oxygenation:

Proceedings of the Eleventh International
Congress on Hyperbaric
President: Wen-ren Li, M.D., Fuzhou, People's Republic of China
Secretariat: Frederick S. Cramer, M.D., San Francisco, California, U.S.A.
Treatment of Children's Epilepsy by Hyperbaric
Analysis of 100 Cases
Wong Qibiao, Wang Hongjun; Chen Linzheng, Zhao Cuiyun
Hyperbaric Oxygen Treatment Centre, Zhou Gulan, EEG Lab, Zhujiang
 More than half of epilepsy patients are children. The treatment is difficult because
    of epilepsy itself and its therapy. In order to find an effective anticonvulsant
treatment for children, we began a treatment using hyperbaric oxygen in 1987. The
                                 result was satisfactory.
Sex and age: The whole group included 100 patients (72 males, 28 females), ages 4 days
to 14 years. Eighty-four percent of them were between 1 month and 9 years old.
Causes of disease:
The causes in 23 patients were unknown (primary epilepsy), while others had the
following established causes:

cerebral lesion due to birth injury in 55 patients;
encephalitis in 14 patients;
high fever in 2 pediatric patients;
anoxic cerebropathy in 4 children;
brain tumor in 1 child;
cerebrovascular malformation in 1 child.
Neuropsychiatric manifestation:
intelligence was impaired in 68 patients:
45 children had mental symptom and personality change;
local neurosystemic signs were detected in 47 patients.
Family history:
In this group, relatives (within three generations) of 4 patients had a history of epilepsy,
while 12 had history of mental disorders. Seven children's parents had consanguineous
Table 1. Patterns of Seizures
     Grand mal
Psychomotor seizures
     Petit mal
   Focal seizures
Autonomic symptoms
EEG examination:
All patients in this group had an EEG test. lt was found that
92 patients had abnormal EEG’s;
66 patients had focal sparkle or sharp wave;
10 patients had paroxysmal sparkle-slow wave and sharp-slow wave;
6 patients had paroxysmal cerebral dysrhythmias;
10 patients had confusing abnormal EEG’s;
3 patients had normal EEG’s;
5 other patients had boundary EEG’s.

CT and MRI scanning:
Seventy-six patients were proved abnormal, including ventricular enlargement due to
atelencephalia, focal encephalatrophy, tumours and local low density pathy, skull
fracture. The other 24 patients were normal.
Seizure frequency:
21 patients seizured every week;
18 patients did every month;
23 patients did every two months,
the other 38 patients seizured more than twice a year.
Anticonvulsant medication:
39 patients were treated systematically
Twenty patients could be controlled by little diazepam and r-amino butyric acid
Forty-one patients received no anticonvulsant because of their parents' objection,
since they thought the children were too young
Some individuals were controlled by luminal intramuscular injection on
Hyperbaric oxygenation treatment:
The private hyperbaric oxygen chamber was manufactured by Ninpo Hyperbaric-Oxygen
Chamber Factory. ln the chamber, the pure oxygen pressure is 1.7-2.0 atmospheres. The
patients were treated for 80 minutes every day. A course was 15-30 days. Some patients
had therefore been treated 35-45 times.
Curative effect:
The treatment was found effective in 82 patients (82%), significantly effective ln
68 patients (68%). It showed that the seizures greatly diminished, and the EEG
was improved.
Forty-three patients had stopped anticonvulsant medication, while in other
patients the amount of antiepileptic was decreased.
After hyperbaric oxygenation treatment, 82 patients' intelligence, personality, and
mentalities were improved; 51 children studied very well; 10 primary and 4
secondary epilepsy children had no change after being treated 30 times.
Electroencephalogram (EEG):

After hyperbaric oxygenation treatment, 45 patients had normal EEG’s; 28 patients had
focal abnormal EEG’s; 3 patients had paroxysmal sharp-slow wave and another 20
patients' EEG’s were slightly abnormal, 4 patients had boundary EEG’s.
Seventy-six patients had been observed for more than 3 years. Forty children had been
completely free of anticonvulsants. Three children had 1 or 2 slight attacks every year.
Twenty-five patients were administered a little anticonvulsants and their seizures
diminished a lot. The attacks did not change in 11 children with systemic therapy.
Questions on pathogeny of children's epilepsy:
The causes of children's epilepsy are varied. Fifty-five of 77 patients (2/3) who had
established causes were due to birth injury. How to prevent this is a complicated problem.
For those fetuses which we guess are too big to labour normally, we suggest an operation
as early as possible, so as to decrease the damage to the brain.
Mechanism of treatment of children's epilepsy with HBO:
Hyperbaric oxygenation could improve the cerebral circulation, provide the brain with
more oxygen, and reduce edema. Hyperbaric oxygen could also promote the energy
metabolism of cerebral cells and improve the recovery of epileptic foci.
Reduction of handicapped children due to epilepsy:
Epilepsy often impairs the children's intelligence and personality; hyperbaric oxygenation
could not only control the attacks of epilepsy but also prevent the occurrence of
intelligence impairment and abnormal personality, so as to diminish the ratio of
handicapped children due to illness.
The way of gaining a good effect in the treatment:
The effect is good in the cases whose causes are known, especially those caused by brain
damage due to birth injury. As to the period of treatment, most patients need 2-3 years. If
the infants do not have high fever or respiratory inflammation, the treatment can begin
from several days after birth. Fifteen to 20 days make a course, and 2 courses a year.

di tayangkan ulang oleh dr.Erick Supondha (hyperbaric&Diving medicine Consultant) Jakarta Indonesia 021 99070050 ,http//