THE SYSTEM OF NEUROTRANSPLANTATION IN SURGICAL TREATMENT OF EPILEPSY

V.P. Bersnev, T.S. Stepanova, V.N. Ovechko, K.E. Lebedev, B.A. Khachatryan

Polenov Neurosurgical Institute

Treatment of patients with drug-resistant epilepsy and a cerebroorganic syndrome caused by a marked and diffuse lesion of the brain of anteperinatal genesis (data of CT, MRI) was started in 1990. It was done with the help of reconstructive operations in the form of intracerebral intraparenchyma somatotopic transplantation of fragments of embryonal nervous cerebral tissue under the control of EEG, electrocorticography, electrosubcorticography and topographic mapping.

Dynamic observation of 70 operated patients aged 2-15 was carried out. A clinical picture of the disease was characterized by an epileptic syndrome manifesting itself in frequent paroxysms (generalized convulsive fits, focal fits without generalization), a syndrome of locomotive disorders, emotional and memory disturbances, mental retardation. The rate of epileptic paroxysms varied from 20 times a day up to 2 times a year. EEG was indicative of predominance of generalized paroxysmal changes with disorganization of cortical rhythms and involvement of subcortical structures as well as structures of the brain stem into a pathologic process.

The long-term follow-up (up to 5 years) and the results of neurotransplantation showed positive dynamics manifesting itself in less marked locomotive disorders and paroxysmal epileptic manifestations. There was considerable reduction of the rate of epileptic fits or their complete disappearance. It correlated with objective decrease of generalized and focal changes watched on electroencephalograms and topographic maps of the brain.