Tag Archive for: Chima Oluigbo

Doctors performing bilateral high intensity focused ultrasound (HIFU) pallidotomy on a patient with dyskinetic cerebral palsy.

Children’s National performs first ever HIFU procedure on patient with cerebral palsy

Doctors performing bilateral high intensity focused ultrasound (HIFU) pallidotomy on a patient with dyskinetic cerebral palsy.

HIFU is a non-invasive therapy that utilizes focused ultrasound waves to thermally ablate a focal area of tissue.

In January, a team of multidisciplinary doctors performed the first case in the world of using bilateral high intensity focused ultrasound (HIFU) pallidotomy on Jesus, a 22-year-old patient with dyskinetic cerebral palsy.

The procedure is part of a clinical trial led by Chima Oluigbo, M.D., pediatric neurosurgeon at Children’s National Hospital.

“The primary objective of the study is to evaluate the safety of ExAblate Transcranial MRgFUS as a tool for creating bilateral or unilateral lesions in the globus pallidus (GPi) in patients with treatment-refractory secondary dystonia due to dyskinetic cerebral palsy,” Dr. Oluigbo explained. “The secondary purpose is to assess the impact of HIFU pallidotomy on dyskinetic cerebral palsy movement disorder in pediatric and young adult patients.”

In addition, the impact of bilateral pallidotomy on motor development, pain perception, speech, memory, attention and cognition in these patients will be assessed.

“We hope that the trial will help us find results that lead to treatments that can reduce the rigidity and stiffness which occurs in cerebral palsy so we can help these children who do not have any effective treatment,” Dr. Oluigbo added.

“This new, first of its kind, non-invasive therapeutic approach – without even a skin incision – will open the door to offering hope for a number of kids with movement disorders who have failed conventional therapy,” said Robert Keating, M.D., chief of neurosurgery at Children’s National. “We are at the beginning of a new era for treating functional disorders in the pediatric patient.”

How it works

HIFU is a non-invasive therapy that utilizes focused ultrasound waves to thermally ablate a focal area of tissue. In the past, Children’s National successfully used HIFU to treat low-grade type tumors located in difficult locations of the brain, such as hypothalamic hamartomas and pilocytic astrocytoma, as well as for epilepsy and other movement disorders.

This most recent procedure was another successful milestone for the hospital, discharging Jesus the following day without any complications.

The team comprised neurosurgeons, MRI techs, anesthesiologists and radiologists, to name a few.

Originally, Jesus came to Children’s National in 2006 when he started working with the Physical Medicine and Rehabilitation team to help him with his muscle hypertonia management as well as equipment, orthoses and therapy concerns.

“As he continued to grow, his muscle hypertonia became more pronounced and caused difficulty with his care, positioning and comfort,” said Olga Morozova, M.D., pediatric rehabilitation specialist at Children’s National. “We have tried multiple oral medications however he has had significant side effects from the majority of the medications.”

Dr. Morozova and Julie Will, M.S.N., F.N.P., the nurse practitioner that worked with Jesus, referred him to Dr. Oluigbo after they learned about HIFU being an option to treat Jesus using a non-invasive approach.

Moving the field forward

This clinical trial highlights the expanding indications for focused ultrasound.

“We are excited about the potential for these innovative treatment strategies in neurosurgery to transform the lives of pediatric patients who suffer from challenging diseases, such as brain tumors, epilepsy, and movement disorders,” said Hasan Syed, M.D., co-director of the Focused Ultrasound Program at Children’s National. “We are redefining what is possible in neurosurgery.”

From low-intensity focused ultrasound (LIFU) treatments for our young DIPG patients to now the groundbreaking research on HIFU for pediatric movement disorders, the dedication to cutting-edge techniques highlights the team’s commitment to patients and transforming pediatric neurosurgical care.

illustration of neurons with electrical impulses

Children’s National at the American Epilepsy Society Annual Meeting

illustration of neurons with electrical impulsesSeveral experts from Children’s National Hospital will be sharing their knowledge at the upcoming American Epilepsy Society Annual Meeting in Orlando, December 1-5. Here’s a sample of what you can expect.

  • Chima Oluigbo, M.D., a pediatric neurosurgeon, will be on panel with other surgeons discussing different surgical techniques and approaches related to epilepsy surgery followed by hands-on practice at teaching stations. He will focus on extra-temporal epilepsy scenarios and will be presenting on Nuances of Temporal Lobe Surgery in the Pediatric Population at the Neurosurgery Symposium highlighting Surgical Controversies in Temporal Lobe Epilepsies.
  • Ersida Buraniqi, M.D., a child neurologist, will be part of a special interest group on critical care and discuss advances in electroencephalography (EEG) and multimodal neuro-monitoring for seizures in the intensive care unit (ICU). Dr. Buranigui will be doing a special presentation on EEG features to predict electrographic seizures and mortality in the pediatric intensive care unit (PICU).
  • Dana Harrar, M.D., director of Pediatric Stroke Program and co-director of Critical Care Neurology, is presenting at an invitation-only resident EEG course, providing an interactive structured curriculum on pediatric and adult EEG. Dr. Harrar will be focusing on doing an ICU-EEG nomenclature overview.
  • Madison Berl, Ph.D., director of Neuropathy Research and of the Intellectual and Developmental Disabilities Research Center Program, will be presenting during the AES Annual Course. The topic “It’s About Time” will focus on the critical importance the timing in epilepsy care plays in patient outcome. Dr. Berl will be presenting on neuropsych outcomes.
  • Leigh Sepeta, Ph.D., director of Inpatient Neuropsychology, is the vice-chair of the special interest group on neuropsychology. Additionally, Freya Prentice, M.Sc., will be doing a presentation during this session on functional mapping of the cognitive memory circuit in pediatric epilepsy.
Date Time Presenter(s) Title
12/2/23 8:00 am Chima Oluigbo, M.D., FRCSC, FAANS Skills Workshop | Epilepsy Surgery Workshop: Techniques and Clinical Scenarios
12/2/23 5:30 pm Chima Oluigbo, M.D., FRCSC, FAANS SIG | Epilepsy Surgery: Homunculus Revisited: Managing Central Lobe Epilepsies
12/2/23 5:30 pm Ersida Buraniqi, M.D. SIG | Critical Care: Advances in EEG and Multimodal Neuro-monitoring for Seizures in the ICU
12/2/23 7:00am Dana Harrar M.D. Resident EEG Course
12/3/23 9:00 am Chima Oluigbo, M.D., FRCSC, FAANS Neurosurgery Symposium | Surgical Controversies in Temporal Lobe Epilepsies
12/3/23 8:45 am Madison Berl, Ph.D. Annual Course | It’s About Time: Timing in Epilepsy Evaluation and Treatment
12/4/23 7:00 am Leigh Sepeta, M.D. SIG | Neuropsychology: Mapping Cognition in Epilepsy: From the Lab to the Clinic
12/4/23 7:00 am Freya Prentice, M.D. SIG | Neuropsychology: Mapping Cognition in Epilepsy: From the Lab to the Clinic
12/5/23 7:00 am Dana Harrar M.D. SIG | Epilepsy Education: Epilepsy Education Throughout the Training Pipeline

 

brain network illustration

Changing the surgical evaluation of epilepsy

brain network illustrationThe choice between stereoelectroencephalography (SEEG) and subdural evaluation is not mutually exclusive, according to a new opinion piece published in JAMA Neurology.

In their article, Chima Oluigbo, M.D., pediatric epilepsy neurosurgeon, William D. Gaillard, M.D., division chief of Epilepsy and Neurophysiology and Neurology, both at Children’s National Hospital, and Mohamad Z. Koubeissi, M.D., M.A., from The George Washington University Hospital, discuss how the practicing epileptologist requires a profound understanding of the roles of different technologies. It also looks at how to integrate both traditional and emerging paradigms to optimize seizure control. This issue is particularly relevant to choosing the best method of invasive intracranial electroencephalography monitoring in individual cases.

Noting that despite the dramatic increase in SEEG use in recent years, the authors talk about how many patients still benefit from invasive monitoring using subdural grids. Therefore, it is important to define the considerations that should guide decision-making on the choice of SEEG versus subdural monitoring in each patient. The authors expand on their statement explaining that it is critical to define the roles of SEEG vs subdural grid investigation in each patient as subdural grid evaluations are still indicated in specific circumstances.

Additionally combined hybrid deployment of both techniques may be indicated in specific situations. Accommodation should be made to allow customization of the technique chosen to available technical expertise and equipment as well as patient preference.

Jake and Dr. Oluigbo

Doctors at Children’s National give Jake his life back

Jake and Dr. Oluigbo

At the age of 17, Jake underwent surgery led by neurosurgeon Chima Oluigbo, M.D., where he conducted a temporal lobe resection, also called temporal lobectomy, that works to lower the number of seizures, make them less severe or stop them completely. The surgery ended up being successful and it worked to greatly improve his overall quality of life.

Since 1969, November has been considered Epilepsy Awareness Month to highlight the importance of recognizing a seizure and promoting seizure first aid. At Children’s National Hospital, doctors in the division of neurology are committed to finding treatments for epilepsy and have done just that by helping Jacob Yates, an 18-year-old patient, get his life back.

For many families the holidays are meant for spending time with loved ones and enjoying the seasonal festivities. However, the holidays were not always a joyous occasion for Jake and his family. Since he was a baby, many of his holidays were spent in a bed due to a brain disorder that caused him to have developmental delays and, at times, up to 17 seizures a day.

“The holidays were always a tough time for the family because Jake would get so excited around Christmas that it would overwhelm his system and induce seizures that took him days to recover from,” says his mom, Jennifer.

Jake was born a preemie and hours after he was born, doctors at his local hospital had identified that he was having trouble breathing. By coincidence, the Children’s National transport team was on-site to take another patient to Children’s National, but once they looked at Jake they immediately took him instead by SkyBear Air Transport, the hospital’s rapid helicopter transport service.

During his stay at Children’s National, Jake was in the neonatal intensive care unit (NICU) for 11 days and was supported by breathing machines to help with respiratory distress and other issues stemming from him being born prematurely.

“If it wasn’t for the Children’s National transport team coincidentally being at our local hospital, Jake wouldn’t have survived staying at that location,” said Jennifer.

After he was taken care of at Children’s National, he was discharged 11 days later, but at the age of three months Jake was still experiencing respiratory issues and was taken back to his local hospital in Charles County.

“When he first arrived back at the University of Maryland Charles Regional Medical Center, the doctors thought he may have had cystic fibrosis, but it came back that perhaps he was suffering from reflux and they put him on medication,” Jennifer recalls. Unfortunately, this was not the cause and it would not be the family’s last visit to the hospital.

By the age of six months, Jake had his first seizure and he was flown back to Children’s National. Over the next year he was repeatedly admitted to the hospital as his seizures had caused him to stop breathing.

Between the ages of 4 to 6 years old, Jake became a patient of William D. Gaillard, M.D., division chief of epilepsy and neurophysiology and Roger Packer, M.D., senior vice president at the Center of Neuroscience and Behavioral Health at Children’s National. After his visit, both doctors recommended surgery, but Dr. Packer recommended that Jake receive an electroencephalogram (EEG), magnetic resonance imaging (MRI) and go through a sleep study first to identify the specific causes of his seizures.

Now on a new medication, his seizures were maintained for the most part, but doctors were still recommending that it was time for surgery. When Jake was 15, his parents re-evaluated the surgery and learned that their son had a 76% chance of being seizure and medication free.

At the age of 17, Jake underwent surgery led by Chima Oluigbo, M.D., neurosurgeon at Children’s National, where he conducted a temporal lobe resection, also called temporal lobectomy, that works to lower the number of seizures, make them less severe or stop them completely. The surgery ended up being successful and it worked to greatly improve his overall quality of life.

Before the surgery, Jake didn’t speak much, experienced anxiety and had difficulty expressing his emotions. He had never told his mother that he loved her. After the surgery, Jake looked at his mother and said, “I love you babe.”

According to Jennifer, since the surgery her son is a completely different person and states that he has been seizure free for over a year. Equally, Jake and the family can now all look forward to the holidays.

“We’re so excited to have him share the holidays,” Jennifer says. “He feels better and it shows through his attitude and the way he responds to things. Words can’t express the gratitude we have for the doctors at Children’s National Hospital. They gave my son his life back.”