UAB’s Oh receives prestigious lifetime award from AANEM
Oh honored with lifetime award from the American Association of Neuromuscular and Electrodiagnostic Medicine.
Shin J. Oh, M.D., professor in the Department of Neurology at the University of Alabama at Birmingham, will receive a lifetime achievement award from the American Association of Neuromuscular and Electrodiagnostic Medicine. The award recognizes the breadth and depth of his contributions to the electrodiagnostic and neuromuscular fields.
“Dr. Oh is internationally recognized as a pioneer in electrodiagnostic and neuromuscular medicine, and has contributed significantly to our clinical diagnosis and treatments in the field over the last four decades,” said Eroboghene E. Ubogu, M.D., professor of neurology and neurobiology and director of the UAB Division of Neuromuscular Diseases. “His legacy at UAB is unquestionable, and he is richly deserving of the 2015 AANEM Lifetime Achievement Award, which formally recognizes his career long excellence in patient care, education and research.”
Oh obtained his medical degree from Seoul National University, Seoul, Korea, followed by residency in neurology at Georgetown University in Washington, D.C. In 1970, he joined the faculty of the UAB School of Medicine, becoming chief of Neurology at the Veterans Affairs Medical Center, as well as the director of the electromyography and evoked potential laboratory, and director of the Muscle and Nerve Histopathology Laboratory, titles he would hold for the next 40 years — one of the longest such tenures in the history of American medicine.
“It is humbling to receive the highest honor given by the AANEM — the one professional organization I have treasured most throughout my career,” said Oh. “I can proudly show this to my grandchildren, telling them that their grandpa has played a small but significant role in the development of electrodiagnostic medicine.”
Oh has served in many capacities for the AANEM, including chairing numerous committees, courses and workshops over the last four decades. Through his continuous involvement with the AANEM, he has broadened knowledge of electrodiagnostic and neuromuscular medicine by identifying unresolved clinical and research issues, designing and performing research, and publishing conclusions.
A prolific author, he has produced 230 articles, 28 books and book chapters, and 237 abstracts. He is an exceptional educational writer with a particular gift for clearly and directly explaining even the most complex of physiological and histological methods. He has also written numerous texts that have become classics of the field.
By: Bob Shepard
UAB Media Relations
Oh selected by the American Association of Neuromuscular and Electrodiagnostic Medicine for their Lifetime Achievement Award
Details of the award are posted on the AANEM website:
UAB’s ROSA robot guides new epilepsy procedure
For epilepsy patients who are interested in epilepsy surgery, determining the precise location of the area within the brain that produces abnormal electrical activity and causes seizures is the key. Once that location is pinpointed, and if it’s not too close to a critical area (for speech or motor centers, for example), it can be surgically removed.
For some patients, nonsurgical investigations are sufficient to determine the area of seizure onset and allow patients to go directly to a potentially curative surgery. However, for many patients with epilepsy, the non-invasive studies do not provide enough information to proceed to surgery. For these patients, direct intracranial recording of brain activity, specifically seizure activity, is required.
In order to perform direct intracranial recording, the patient undergoes an operation to place electrodes directly on the brain or within the brain. This allows for electroencephalography, or EEG, to record electrical activity in the brain. For intracranial EEG, the traditional approach has been for the surgeon to perform a craniotomy, in which they remove a large section of the patient’s skull, and then lay a grid of electrodes directly on the brain.
The electrodes remain in place for up to two weeks while the patient resides in a seizure monitoring unit. As seizures occur, the corresponding electrical activity is noted, and epilepsy physicians can determine if surgery is an option, and if so, where to cut. But, having a large piece of skull removed for several weeks is a very invasive surgery. It can be painful and uncomfortable, and carries risks including a risk of infection.
|“The ROSA robot allows us to very safely, efficiently and precisely place the sEEG electrodes. With the robot, we can efficiently move from one electrode trajectory to the next. The robotic precision tracks multiple trajectories, ensuring that each electrode is placed in the safest, most optimal position.”
“Instead of using this very invasive procedure requiring a craniotomy and exposing the brain, we can drill small burr holes in a skull and place the electrodes directly inside the brain,” said Jerzy Szaflarski, M.D., Ph.D., professor in the Department of Neurology and director of the UAB Epilepsy Center. “Over the past few years we have learned that sEEG provides a much less invasive approach and we have implemented this approach at UAB in 2013.”
And UAB is one of the first U.S. hospitals to obtain the ROSA robot, produced by Medtech. ROSA, which the company calls ‘a reliable and accurate surgical assistant’, fine tunes the sEEG process. Using standard scalp EEG and MRI images, the team first maps the region of the brain where the seizure locus is suspected to lie. The optimal positioning of the electrodes to confirm the seizure locus is plotted. ROSA, which works in three dimensions, aids in the precise placement of the electrodes.
“The ROSA robot allows us to very safely, efficiently and precisely place the sEEG electrodes,” said Kristen Riley, M.D., associate professor in the Department of Neurosurgery. “With the robot, we can efficiently move from one electrode trajectory to the next. The robotic precision tracks multiple trajectories, ensuring that each electrode is placed in the safest, most optimal position.”
ROSA’s robotic arm unerringly moves to each pre-plotted point. The surgeon drills into the skull and secures an anchor bolt. The electrode is then fed to the desired depth and its leads are connected to a monitor. ROSA then moves to the next position and the process is repeated.
ROSA allows for the placement of numerous arrays of electrodes, including bilateral placements, each with multiple contacts, at varying depths in the brain. This provides for much more complete coverage and a more accurate determination of the seizure locus.
“sEEG is a much less invasive procedure than the craniotomy with subdural grid procedure,” said Riley. “From a patient standpoint, sEEG causes much less discomfort. While it is still a surgical procedure, there is less pain, less discomfort, and patients are much more comfortable in the seizure monitoring unit with the stereo EEG electrodes in place.
Riley and Szaflarski say that the complication profile for sEEG is far less than that of the craniotomy/subdural grid approach.
“We see a lot of potential in the sEEG procedure,” Szaflarski said. “We are still exploring the full capabilities of this approach and we are gradually moving to implement sEEG on a regular basis.”
The UAB Epilepsy Center is one of the largest and most active in the nation and the only one in Alabama. It is a Level 4 Center, the highest designation from the National Association of Epilepsy Centers. The center has the capability to diagnose and treat epilepsy using the latest and most current medical and surgical techniques available anywhere in the world.
“We have the full gamut of epilepsy therapies available at UAB, but we are constantly in search of new and improved treatments,” said Szaflarski. “Currently available therapies work well in approximately 60-70 percent of patients.”
By: Bob Shepard
UAB Media Relations
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