Ðe mèle atike si sɔ hã xɔm na wò asrãdɔa oa? Èse SEEG (Stereoelectroencephalography) ŋkɔ kpɔa?

Aɖuɖɔtoedɔ nye nɔnɔme si ɖea dzi le ame ƒo ŋutɔŋutɔ, alo? Ɣeaɖewoɣi la, esesẽna ŋutɔ be woaɖu edzi ne wozã atike gɔ̃ hã. Eyata ne kuxi sia tɔgbe le ŋuwò la, SEEG sia si ŋu míaƒo nu tsoe egbea ate ŋu anye nane si ate ŋu ahe mɔkpɔkpɔ yeye vɛ na wò. Na míakpɔ nusi wònye ɖaa?

Nukae nye SEEG (Stereoelectroencephalography)? Kpuie ko la,...

Kpuie ko la, SEEG (Stereoelectroencephalography) nye dodokpɔ si de ŋgɔ vie si kpena ɖe ŋuwò nèkpɔa afisi tututu wò ahɔhɔ̃medɔa dze egɔme tsoe le wò ahɔhɔ̃ me. Ele abe amekoko ene, gake wowɔa esia le sue ŋutɔ, evɔ wometsoa nu gã aɖeke o.

Ðewohĩ èse EEG (electroencephalogram) si wozãna edziedzi ŋu nya kpɔ. Edzidzea elektrikŋusẽ si le wò ahɔhɔ̃ me tso wò ta ƒe anyime. Gake to SEEG dzi la, ahɔhɔ̃ŋutinunyalawo tsɔa elektrikŋusẽnamɔ̃ suesuesuewo dea wò ahɔhɔ̃ ƒe akpa siwo goglo wu me. Esia wɔnɛ be wòte ŋu dea dzesi alɔ̃madɔmadɔ siwo ɖewohĩ EEG edziedzi mafɔ o, eye wodzea egɔme tso wò ahɔhɔ̃ me goglo.

Ne wotsɔ elektrikŋusẽnamɔ̃ siawo de eme vɔ la, woatsɔ wò ade dɔwɔƒe tɔxɛ aɖe le kɔdzi ŋkeke ʋɛ aɖewo, eye asrãdɔlélawo ƒe ƒuƒoƒo aɖe alé ŋku ɖe wò alɔ̃madɔmadɔ ŋu. Esia akpe ɖe wo ŋu woase nusi tututu le wò asrãdɔa hem vɛ kple afisi wòdze egɔme tsoe le ahɔhɔ̃a me gɔme.

Bu eŋu kpɔ, abe ʋɔnudrɔ̃la ene la, SEEG sia kpena ɖe ame ŋu wòkea asrãdɔ ƒe ke si ɣla ɖe ahɔhɔ̃a me goglo!

Ɣekaɣie wowɔa SEEG dodokpɔ?

Ðɔktawo kafui be woawɔ SEEG dodokpɔ, vevietɔ le nɔnɔme siwo gbɔna me:

• Le amesiwo ŋu asrãdɔ si me atikewo te ŋu nɔa te ɖo gome: Le ame aɖewo gome la, asrãtike ƒomevi eve gɔ̃ hã mewɔa dɔ nyuie o. Le ame mawo gome la, SEEG dodokpɔ sia le vevie ŋutɔ be woatsɔ anya nenye be woate ŋu awɔ dɔ na ame aɖe atsɔ aɖe ahɔhɔ̃a ƒe akpa si le asrãdɔa hem vɛ la ɖa.
• Nuto veviwo ƒe nɔnɔmetata wɔwɔ hafi woawɔ ahɔhɔ̃a: Ɣeaɖewoɣi hafi woawɔ ahɔhɔ̃a ƒe dɔwɔwɔ la, ehiãna be woanya ahɔhɔ̃a ƒe akpa siwo tututu le vevie na nuwo abe nuƒoƒo kple ʋuʋu ene. Emegbe le amekokoa wɔɣi la, woate ŋu akpɔ teƒe mawo ta evɔ womagblẽ nu le wo ŋu o. SEEG ate ŋu akpe ɖe eŋu le ema hã me.
• Abe mɔfiame na atikewɔwɔ bubuwo ene la:
• (Radiofrequency thermocoagulation): Esia zãa radio ƒe ƒutsotsoewo kple dzoxɔxɔ ƒe ŋusẽ tsɔ tsrɔ̃a ahɔhɔ̃menugbagbevi siwo hea asrãdɔ vɛ.
• (Thermoablation) alo (Laser Interstitial Thermal Therapy - LITT): Le go sia me la, wozãa dzoxɔxɔŋusẽ tsɔ tsrɔ̃a ahɔhɔ̃a ƒe akpa siwo hea asrãdɔ vɛ.
• (Responsive neurostimulation): Le esia me la, wonaa dzideƒoname vaseɖe afisi alɔ̃madɔmadɔa dze egɔme tsoe (seizure focus).

Hafi woawɔ atike mawo la, wozãa SEEG tsɔ dea dzesi afisi tututu alɔ̃madɔmadɔa le. Esia nye dodokpɔ si woate ŋu awɔ na ɖevi siwo xɔ wu ƒe eve kple ame tsitsiwo.

Ðe medze na SEEG dodokpɔa? Aleke mawɔ anya?

Menye asrãdɔléla ɖesiaɖee hiã SEEG o. Ðɔktawo kafui ne wobu nu aɖewo ŋu vɔ.

Zi geɖe la, ne dodokpɔ bubuwo, abe MRI (Magnetic Resonance Imaging) ene, meƒo nya ta o ko hafi woɖoa amesiwo ŋu asrãdɔ le la dometɔ siwo ade 20% ɖe SEEG. Ne asrãdɔ le ŋuwò si bɔ la, ke mèdze na dodokpɔ sia o.

Wò dɔwɔla bibi ate ŋu akafu dodokpɔ sia le susu siwo gbɔna ta:

• Ne àte ŋu anye ame nyui aɖe si woawɔ dɔ na wò le asrãdɔ ta.
• Ne alɔ̃madɔmadɔ siwo ƒe akpa aɖewo le teƒe ɖeka alo esiwo sesẽ, eye wometsɔ atike ɖeka alo eve ɖu wo dzi nyuie o.
• Ne dodokpɔ bubuwo me tsonu me mekɔ o.

Vovototo kae le EEG si wozãna edziedzi kple SEEG dome?

Vovototo vevi siwo le wo ame evea domee nye:

• SEEG xɔa wò ahɔhɔ̃ ƒe akpa gã aɖe.
• Le SEEG me la, woɖoa elektrikŋusẽnamɔ̃wo ɖe ahɔhɔ̃a ƒe akpa siwo goglo wu .

EEG si wozãna ɖaa bia be woatsɔ ga gbadzɛ suewo (elektrode) abla wò tagbɔ be woatsɔ aŋlɔ elektrikŋusẽ si le wò ahɔhɔ̃a me la ɖi. Le vidzĩwo kple ɖevi siwo mexɔ ƒe eve haɖe o gome la, zi geɖe la, EEG sɔ wu SEEG.

Zi geɖe la, woawɔ electroencephalogram (EEG) dodokpɔ (a `phase 1 test`) gbã. Esia adze agbagba anya afisi wò asrãdɔa dze egɔme tsoe. Gake ne emetsonu mawo me mekɔ o, alo ne ahɔhɔ̃ŋutinunyala hiã nyatakaka bubuwo la, woate ŋu aɖo aɖaŋu be woawɔ SEEG (a `phase 2 test`).

Esi wònye be SEEG léa nyatakakawo tso gogloƒe vovovowo le ahɔhɔ̃a ƒe akpa eveawo ta la, ele bɔbɔe na ɖɔkta be wòakpɔ afisi tututu alɔ̃madɔmadɔa le.

Numekuku aɖe ɖee fia be amesiwo ŋu SEEG le hafi wowɔ dɔ na wo le asrãdɔ ŋu la zãa ɣeyiɣi ʋɛ aɖewo le amekokoxɔa me wu amesiwo si EEG tɔxɛ aɖe si woyɔna be subdural intracranial EEG le. Amesiwo ŋu SEEG le hã nɔa kɔdzi ɣeyiɣi kpui aɖe eye womezãa vevesesenutsitike ʋɛ aɖewo o.

Nukae dzɔna hafi woawɔ SEEG dodokpɔa? Nukae wòle be makpɔ mɔ na?

Wò atikewɔlawo ƒe ƒuƒoƒoa aɖo aɖaŋu na wò le alesi nàdzra ɖo ɖe wò SEEG ŋui ŋu. Zi geɖe la, esia alɔ dodokpɔ ʋɛ aɖewo kpee be woakpɔe ɖa be ènye ame nyui si woate ŋu awɔ dɔ na hã. Le kpɔɖeŋu me:

• Ʋudodokpɔwo.
• Dzi ƒe tsotso dodokpɔ (Electrocardiogram - EKG) .
• Nɔnɔmetata dodokpɔwo abe `(CT scan)` (Computed Tomography scan) kple `(MRI)`.

Àte ŋu atsi dzi be woatso wò alo viwòa ƒe taɖa, alo nenye be ahiã be woaɖe woƒe asrãtikewo dzi akpɔtɔ alo adzudzɔ hafi woawɔ SEEG.

Dzro vɔvɔ̃, ɖikeke, alo nyabiase ɖesiaɖe si anɔ asiwò me kple wò atikewɔlawo hafi woawɔ dɔ na wò. Woakpe ɖe ŋuwò be mia kple viwòa miaɖe dzi ɖi ahanɔ nuteɖeamedzi manɔmee alesi nàte ŋui.

Nukae dzɔna le SEEG ƒe amekoko me?

Zi geɖe la , SEEG ƒe dɔwɔwɔ xɔa abe gaƒoƒo ene va ɖo ade ene . Gbesigbe woawɔ dɔa na wò la, atikewɔla si naa alɔ̃dɔdɔ ame ana atike si naa alɔ̃dɔdɔ wò. Àdɔ alɔ̃ keŋkeŋ, eyata màse veve aɖeke o.

Ne èdɔ alɔ̃ vɔ la, amekolawo ƒe ƒuƒoƒoa awɔ nu siwo gbɔna:

• Wotsɔa xɔtunu sesẽ aɖe (stereotactic frame) blaa wò ta ŋu be wòanɔ anyi kpoo.
• Woawɔ do suesuesue siwo ade 10 va ɖo 20 le wò ta me, siwo ƒe kekeme anɔ abe spaghetti ka ene . Esia mana ʋu aɖeke nado le ame ŋu o.
• Wotsɔa elektrɔnik (siwo wotsɔ do ka kple ka), siwo le abe aŋe suesuesue siwo te ŋu trɔna ene la dea do siawo me.
• Wotsɔa elektrikŋusẽnamɔ̃ siawo dana ɖe wò ahɔhɔ̃ ƒe akpa siwo dodokpɔ siwo wowɔ va yi ɖee fia be wò asrãdɔa dze egɔme tsoe.
• Woɖea ta ƒe xɔmenuwo ɖa eye wotsɔa aŋe blaa ta.
• Emegbe woakplɔ wò ayi xɔ si me woahaya le, afisi woawɔ CT-dɔdamɔnu kple X-ray na wò le be nàkpɔ afisi tututu elektrikŋusẽnamɔ̃awo le.

Nukae dzɔna le SEEG megbe?

Le SEEG megbe la, zi geɖe la, woaɖo wò ɖe Epilepsy Monitoring Unit (EMU) gbɔ. Le afima la, ɖɔktawo ƒe ƒuƒoƒo aɖe alé ŋku ɖe ŋuwò be lãmetutudɔ le ŋuwò hã. Wotsɔa elektrikŋusẽnamɔ̃awo doa ka kple mɔ̃ siwo léa wò ahɔhɔ̃ ƒe dɔwɔwɔ ɖi. Emegbe kɔmpiuta wɔa 3D nɔnɔmetata siwo ɖea alesi wò alɔ̃madɔmadɔ dzea egɔmee kple alesi wòyia edzii fiana.

Le zi nenie wòxɔa asrãdɔ nu la, ahiã be nànɔ kɔdzi ŋkeke ʋɛ aɖewo va ɖo kwasiɖa ʋɛ aɖewo . Zi geɖe la, ànɔ afima abe kwasiɖa ɖeka ene. Ne wonya wɔ dodokpɔawo katã ko la, wò atikewɔlawo aɖe wò elektrikŋusẽnamɔ̃wo ɖa. Enye dɔ bɔbɔe ŋutɔ aɖe si xɔa abe miniti 10 va ɖo 15 ene eye wowɔa esia le atike si wua alɔ̃dɔdɔ le teƒea me.

Ðe afɔku aɖewo le SEEG dodokpɔa mea? Nukawoe nye eƒe nugbegblẽ le ame ŋu?

Zi geɖe la, wobua SEEG be enye dodokpɔ si le dedie . Gake abe nusianu si wowɔna ɖe ahɔhɔ̃a ŋu ene la, ate ŋu ahe afɔku aɖewo vɛ. Esiawo dometɔ aɖewoe nye:

• Ʋu si dona le ahɔhɔ̃a me (`(ahɔhɔ̃ me ʋu / ʋu si dona le tagbɔ me)`).
• Dɔdzedze.
• Ele abe ʋusɔgbɔdɔ ene.

Gake mègatsi dzi o, ɖɔktawo le nusianu si woate ŋui wɔm be woaɖe afɔku siawo dzi akpɔtɔ.

Ɣeyiɣi didi kae wòxɔna hafi wòhayana le SEEG megbe?

Wò atikewɔlawo ƒe ƒuƒoƒoa agblɔ ɣeyiɣi si nàhaya keŋkeŋ eye nàte ŋu adze dɔ siwo nèwɔna ɖaa gɔme ake. Zi geɖe la , àdze egɔme ƒe lãme sẽ ŋutɔ le gaƒoƒo 24 va ɖo 48 me .

Nukae woate ŋu akpɔ mɔ na tso SEEG dodokpɔ me?

SEEG dodokpɔa me tsonu nɔ te ɖe nusiwo atikewɔlawo ƒe ƒuƒoƒoa kpɔ le ŋkuléleɖenuŋu ƒe ɣeyiɣia me dzi. Zi geɖe la, SEEG ate ŋu afia afisi tututu dɔlélea le. Eŋutinunyalawo alé ŋku ɖe wò ahɔhɔ̃ ƒe dɔwɔwɔ ƒe nuŋlɔɖi siwo wolé ɖe mɔ̃ dzi ŋu nyuie eye woatso nya me nenye be èdze na amekoko alo asrãdɔ ƒe atikewɔwɔ bubuwo. Zi geɖe la, wowɔa dɔ na ame be woatsɔ ada asrãdɔ le kwasiɖa ene va ɖo enyi le SEEG megbe, si naa ɣeyiɣi wò be nàhaya.

Ɣekaɣie woanya SEEG ƒe emetsonuwo?

Àte ŋu axɔ ŋgɔdonya aɖewo hafi adzo le kɔdzi. Gake hafi woawu wò atikewɔwɔ ƒe ɖoɖoa nu la, ɣeyiɣi anɔ mia kple wò ƒomea si miadzro nu mamlɛawo me kple atikewɔlawo ƒe ƒuƒoƒoa ahawɔ nyametsotsowo.

Mlɔeba la, ele nam be magblɔ be... (Take-Home Message)

Agbenɔnɔ kple asrãdɔ, si nye dɔléle si dzi womate ŋu aɖu kple atike o eye wòdzea egɔme tso ahɔhɔ̃a ƒe akpa ɖeka, ate ŋu anye kuxi ŋutɔŋutɔ. Ðewohĩ ànɔ ɖokuiwò biam be nukae nye wò tiatiawɔblɔɖewo hã.

SEEG nye amekoko si le dedie eye wòkpɔa dzidzedze zi geɖe, si ate ŋu afia afisi tututu wò asrãdɔa le le wò ahɔhɔ̃ me.

Nyatakaka tsitotsito sia akpe ɖe wò dɔdala bibiwo ŋu woawɔ atikewɔwɔ ƒe ɖoɖo nyuitɔ kekeake, si me amekoko hã ate ŋu anɔ. Ne èwɔ atike nyuie la, wò atikewɔlawo ate ŋu aɖe wò asrãdɔ ƒe dzesiwo dzi akpɔtɔ eye wòakpe ɖe ŋuwò nàganɔ agbe si me dzidzɔ le ake. Eyata mègavɔ̃ be yeaƒo nu tso nya sia ŋu na wò ɖɔkta o.

` Aɖuɖɔtoedɔ, SEEG, Stereoelectroencephalography, Ahɔhɔ̃ ƒe Amekoko, Alɔ̃madɔmadɔ, EEG, Aɖuɖɔtoedɔdada, Ahɔhɔ̃ŋutinunya