 Proceedings of the Eleventh International |
Congress on Hyperbaric
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Medicine
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President: Wen-ren Li, M.D., Fuzhou, People's
Republic of China
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Secretariat: Frederick S. Cramer, M.D., San
Francisco, California, U.S.A.
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Treatment of Children's Epilepsy by Hyperbaric
Oxygenation:
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Analysis of 100 Cases
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Wong Qibiao, Wang Hongjun; Chen Linzheng,
Zhao Cuiyun
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Hyperbaric Oxygen Treatment Centre, Zhou Gulan,
EEG Lab, Zhujiang
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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.
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MATERIALS
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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.
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Causes of disease:
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The
causes in 23 patients were unknown (primary epilepsy), while others had the
following
established causes:
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 1.
2.
3.
4.
5.
6.
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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.
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Neuropsychiatric manifestation:
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•
•
•
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intelligence
was impaired in 68 patients:
45
children had mental symptom and personality change;
local
neurosystemic signs were detected in 47 patients.
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Family history:
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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
marriages.
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Table
1. Patterns of Seizures
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Grand mal
Psychomotor
seizures
Petit
mal
Focal seizures
Autonomic
symptoms
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32
12
10
44
2
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EEG examination:
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All
patients in this group had an EEG test. lt was found that
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•
•
•
•
•
•
•
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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.
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 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.
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Seizure frequency:
|
•
•
•
•
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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.
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TREATMENT
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Anticonvulsant
medication:
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•
•
•
|
•
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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
convulsion.
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Hyperbaric
oxygenation treatment:
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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.
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Curative
effect:
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•
|
•
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•
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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.
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Electroencephalogram
(EEG):
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 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.
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Follow-up:
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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.
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DISCUSSION
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Questions on pathogeny of children's epilepsy:
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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.
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Mechanism of treatment of children's epilepsy
with HBO:
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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.
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Reduction of handicapped children due to epilepsy:
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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.
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The way of gaining a good effect in the treatment:
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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//:wwwindodivinghealth.com
|
