Elise Riquin1, Mickael Dinomais2, Jean Malka3, Thierry Lehousse4, Philippe Duverger3, Philippe Menei5, Matthieu Delion6. 1. Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France. Electronic address: elise.riquin@chu-angers.fr. 2. Physical and Rehabilitation Medicine, University Hospital of Angers, Angers, France. 3. Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France. 4. Department of Anesthesiology, University Hospital of Angers, Angers, France. 5. Department of Neurosurgery, University Hospital of Angers, Angers, France. 6. Department of Neurosurgery, University Hospital of Angers, Angers, France; Anatomy Laboratory, LUNAM, University of Angers, Angers, France.
Abstract
BACKGROUND: Intraoperative direct stimulation during surgery while awake is considered to be the gold standard for identifying eloquent cortical sites. Only a few studies have referenced the psychologic impact of this event in the pediatric population. OBJECTIVE: The aim of this clinical study is to present the psychologic aspects of surgery while awake in children. We question the psychiatric contraindications and age limits, as well as the impact on children, with particular attention to the psychologic conditioning and experience of these patients. METHODS: Seven patients aged 8-16 years old with brain lesions were operated on while awake between 2008 and 2015. Data collected included perception and memories of surgery and diagnosis and also their real-life experience after surgery. Symptoms of posttraumatic stress disorder or acute stress were investigated. RESULTS: None of the children had initial psychiatric problems. No psychiatric diagnosis was made before surgery. The child psychiatrist did not contraindicate any child for this procedure. Patients experienced little anticipatory anxiety. No child presented symptoms of posttraumatic stress disorder or acute stress. CONCLUSIONS: The results are encouraging, allowing us to contemplate using brain surgery while awake for children without particular worries about the psychologic aspect.
BACKGROUND: Intraoperative direct stimulation during surgery while awake is considered to be the gold standard for identifying eloquent cortical sites. Only a few studies have referenced the psychologic impact of this event in the pediatric population. OBJECTIVE: The aim of this clinical study is to present the psychologic aspects of surgery while awake in children. We question the psychiatric contraindications and age limits, as well as the impact on children, with particular attention to the psychologic conditioning and experience of these patients. METHODS: Seven patients aged 8-16 years old with brain lesions were operated on while awake between 2008 and 2015. Data collected included perception and memories of surgery and diagnosis and also their real-life experience after surgery. Symptoms of posttraumatic stress disorder or acute stress were investigated. RESULTS: None of the children had initial psychiatric problems. No psychiatric diagnosis was made before surgery. The child psychiatrist did not contraindicate any child for this procedure. Patients experienced little anticipatory anxiety. No child presented symptoms of posttraumatic stress disorder or acute stress. CONCLUSIONS: The results are encouraging, allowing us to contemplate using brain surgery while awake for children without particular worries about the psychologic aspect.
Authors: Marko Wilke; Samuel Groeschel; Anna Lorenzen; Sabine Rona; Martin U Schuhmann; Ulrike Ernemann; Ingeborg Krägeloh-Mann Journal: Ann Clin Transl Neurol Date: 2018-09-27 Impact factor: 4.511