simple terms a seizure may be described as a sudden change in behaviour triggered by unorganized electrical transmission in the brain which is usually self-limiting. Epilepsy surgery is a broad term used for different types of brain surgeries which are performed to stop or reduce seizures Epilepsy is usually treated by anti epileptic medication as a first line of treatment. Anti epileptic medication occasionally is not sufficient to control the occurrence of seizures, hence surgical intervention is required to improve the patient’s quality of life. Epilepsy surgery is a highly advanced surgical technique which requires skilled specialists to perform the procedure.
What is the goal of an epilepsy surgery ?
The primary goal of epilepsy surgery is to control the seizures without causing any functional disability and to improve the quality of life of the patient which is not achieved by change of anti epileptic medication.
Who is a suitable candidate for epilepsy surgery ?
Surgery is an option for individuals or patients who are diagnosed with epilepsy and the seizures associated with epilepsy are not adequately controlled by change of anti epileptic medication. Patients who are affected with adverse effects of anti epileptic medication and patients who are prone to serious injuries due to epileptic seizures are also potential candidates for a surgical treatment for epilepsy.
How is pre-surgical evaluation for epilepsy surgery done ?
If you are suffering from epilepsy and anti epileptic medication are not helpful in providing appropriate relief or if the side effects of the anti epileptic medication are affecting your overall health then it is advised to consult a neurologist or a neurosurgeon to explore the surgical options. Surgical treatment for epilepsy is a highly advanced procedure which requires skilled and experienced team of neurosurgeons, neurophyscians, psychologists and physicians. The operating team or the consulting specialist would do a complete examination of your overall health, your symptoms and would advise for CT scan, MRI scan, PET (Positron emission topography) and EEG (Electro encephalogram). Radiographic adjuncts also help in evaluation of the site from where the electrical signals which help the operating team in deciding the best suitable procedure for your condition.
The decision of whether to get a surgery done for your condition is solely dependent on your condition and analysis of risks and benefits of each surgical procedure. The operating team will conduct thorough evaluation of your condition and would arrive at a best tailored choice of treatment. The operating team will also run you through the potential complications and the long term benefits of the procedure and the final decision would be taken based on your consent.
What are the different types of surgical options for the treatment if epilepsy ?
Epilepsy is a chronic debilitating disease which has a direct effect on the overall life of the patient affecting his/her day to day activities. Hence any surgical option for treatment of epilepsy aims at improvement in the quality of life. The type of epilepsy surgery is based on its functionality such as ;
- Surgery to eliminate the focal point which is responsible for the production of electrical signals in the brain giving rise to seizures
- Surgery which blocks the conduction pathway of nerves thereby blocking the transmission of electrical signals
- Use of an implant device in the central nervous system to control seizures
Broadly the surgical treatment modalities for epilepsy can be categorized as under.
Lobe Resection: This is the most common option for surgical treatment of epilepsy. The human brain is divided into four paired lobes namely: the frontal, the parietal, the temporal and the occipital depending on its location. Lobe resection can be also categorized as Temporal lobe resection and Extra-temporal lobe resection. In epilepsy the most commonly affected areas are the anterior and medial portion of the temporal lobe. Hence during a lobectomy procedure these areas are surgically removed thereby removing the focus of seizure generation.
Lesionectomy: Lesionectomy as the name connotes is a method of surgically removing the lesion such as a tumor or a large blood vessel triggering the electrical signals which produce seizures.
Corpus Callosotomy: The corpus callosum is a specialised structure made of a band of nerve fibres which connect two parts of the brain. Corpus callosotomy is a surgical procedure which disrupts this nerve connection thereby seizures produced in one part of the brain is not transmitted to another. This procedure is also referred to as Split-brain surgery
Functional Hemispherectomy: As the name suggests this procedure aims at removal of the functional part of brain responsible for generation of seizures from the other parts. This kind of surgical procedure is indicated in children where a particular part of the brain is identified as the cause of generation of seizures.
Multiple Subpial Transection: Also referred to as MST, this procedure is indicated in cases where it is difficult to surgically remove the seizure focus, hence during the procedure the surgeon makes shallow cuts/breaks or transections in the brain tissue thereby interrupting the conduction of seizure from one part of the brain tissue to the other.
Vagus Nerve Stimulation: Vagus nerve is the tenth cranial nerve and is controls the various activities of major internal organs. Vagus nerve stimulation is a surgical procedure wherein an implant is positioned in the brain which controls the electrical impulse generation and hence preventing seizures.
Stereotactic Ablations: Stereotactic ablations are usually carried out for generalised and focal forms of epilepsy. The procedure required tactfully skilled operating team and the results of the procedure are debatable.
Cerebellar stimulation: As the name implies this procedure is dependent on artificial stimulation of the cerebellum which in turn reduces cortical discharges thereby controlling the seizures. Electrodes are usually implanted in the area of the cerebellum to detect the electrical impulses before they are converted into seizures.
Response Neurostimulation Device: During this procedure a neurostimulator made up of 2 electrodes is implanted in the skull beneath the scalp. This neurostimulator detects any abnormal electrical activity in the brain in advance and produces electrical stimulation to counteract the same before the seizure becomes evident, hence the device is also referred to as response neurostimulation device.
Do these procedures require administration of anaesthesia ?
Yes, most of the surgical procedures require administration of anaesthesia.
What are the risks associated with epilepsy surgery ?
The risks of each surgical procedure may vary depending upon the type of the surgery performed. The common risks include bleeding, infection at the surgical site and blood clots. The risks affecting primarily the central nervous system are memory loss, loss of vision, reduced visual field difficulty with balancing and auditory problems.
What results can you expect from epilepsy surgery ?
Some seizures are not controlled by change of anti epileptic medication and hence require a surgical intervention to improve the symptoms and improve the overall quality of patient’s life.
What is the outcome of epilepsy surgery ?
Epilepsy stands as a common neurological disorder which affects a patients day to day activities. Anti epileptic medications are the first line of treatment for any type of epilepsy, but certain patients do not respond well and require surgical intervention. Surgical options for treatment of epilepsy are varied and are used for treating different types of epilepsy. It is essential for an individual suffering from epilepsy to seek appropriate consultation with the team of experts to see if surgery could be the best suitable treatment for their condition and will improve their overall quality of life.
How to find neurosurgeons for epilepsy surgery ?
Now you can find neurosurgeons for epilepsy surgery from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions from multiple neurosurgeons, cost estimates for epilepsy surgery from different hospitals, compare things and then choose a neurosurgeon for epilepsy surgery.
Find and choose a neurosurgeon for epilepsy surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
