Separated twin has seizures, brother fine

One of the Egyptian twins who were separated at the crown of their heads is starting to breathe and move on his own while the other suffered minor seizures leading doctors to continue to keep him in a medically induced coma, his doctor said yesterday.

Dr James Thomas, director of critical care at Children's Medical Centre where the boys were separated in Dallas, said two-year-old Mohamed Ibrahim has moved out of a coma and has shown some movement on one side of his body as he breathes over a mechanical respirator.

His brother, Ahmed, had minor seizures overnight that caused doctors to prolong the medically induced coma that he and his brother had been in since the twins were separated by 18 doctors on Sunday in a 34-hour operation.

"Now that they are coming out of a coma, they are no longer in lock step with one another," Dr Thomas said, adding, "It is to be expected, even though they are twins."

The boys had a slight fever that soon abated overnight, but Dr Thomas said they showed no signs of infection, which is one of several factors that could develop into a life-threatening situation in the crucial post-operative period.

He said that tests on their brains and circulatory systems have not shown any problems, but it may be weeks before doctors will know if the boys suffered any brain damage.

Thomas said the boys have shown an amazing ability to recover from such a complex and intricate medical procedure that included a team of five neurosurgeons separating shared brain material and the shared circulatory systems that feed blood to their brains. "They are doing extremely well. This is remarkable," Thomas told a press conference.

Over the next few days, doctors will try to move the boys off the mechanical ventilators that are helping them breathe and decrease the dosage of sedatives.

The boys are being kept in adjoining rooms because they could not fit together in one room with all the medical equipment needed for them in the intensive care unit. The boys' parents have visited them frequently and have held their hands and spoken with them in quiet tones, Thomas said.