Proceedings of the Eleventh International Congress on Hyperbaric
Medicine
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
Oxygenation: Analysis of 100 Cases
Hyperbaric Oxygen Treatment Centre, Zhou Gulan, EEG Lab, Zhujiang
Sex and age: The whole group included 100 patients (72
males, 28 females), ages 4 days to 14 years. 84% 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:
1. cerebral lesion due to birth injury in 55 patients;
2. encephalitis in 14 patients;
3. high fever in 2 pediatric patients;
4. anoxic cerebropathy in 4 children;
5. brain tumor in 1 child;
6. 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.
Patterns of Seizures:
Grand mal = 32, Psychomotor seizures =12, Petit mal= 10, Focal seizures= 44, Autonomic symptoms= 2,
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.
TREATMENT
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 convulsion.
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.
Follow-up: 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.
DISCUSSION:
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.