Epilepsy is a brain disorder in which a person has repeated seizures (convulsions) over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain. About 50 million people worldwide have epilepsy, and nearly two out of every three new cases are discovered in developing countries. Epilepsy becomes more common as people age. Onset of new cases occur most frequently in infants and the elderly. As a consequence of brain surgery, epileptic seizures may occur in recovering patients.
Epilepsy is usually controlled, but not cured, with medication. However, over 30% of people with epilepsy do not have seizure control even with the best available medications. Surgery may be considered in difficult cases. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms but all involving episodic abnormal electrical activity in the brain.
Why is Epilepsy surgery required?
Epilepsy surgery has proven to be successful in reducing and even eliminating seizures in patients who did not respond well to the epilepsy medications. It is important to get the treatment for epilepsy, repeated seizures may result in:
- Irreparable Brain damage from repeated seizures
- Sudden death, a rare complication
- Injuries from falling / driving during various activities
Till the time a person develops a second seizure, treatment for epilepsy will not begin. This is due to the reason that a person may have one seizure and never develops a second seizure. Medicines are successful in treating epilepsy. These medicines do not cure epilepsy, they prevent recurring of the seizures. These medicines changes the chemical or electrical transmissions in the brain in a particle way that decreases the chance of a seizure.
- Vagus Nerve Stimulation (VNS) : VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one of the nerves on the neck’s left side. This nerve is called as vagus nerve. This device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces the severity and frequency of the seizures. If a person is feeling a warning seizure symptom then extra stimulation is given for preventing recurrence of the seizure.
- Ketogenic Diet : This is also considered as one of the treatment for epilepsy. Ketogenic diet is recommended for children as it involves eating a diet which is low in proteins and carbohydrates and high in fats. The chemical balance of the brain can be altered that also reduces the chance of having seizures. Ketogenic diet is not meant for adults as the diet can result in any other serious medical condition like heart disease, high blood pressure or strokes.
Advanced Surgical Procedures for Management of Epilepsy
Depending on the particular clinical situation, one of the following surgical procedures is chosen by the Medical team at our affiliate hospital. These operations either aim to resect the disease area of the brain, to disconnect it from other areas so as to relieve the seizures, or to lessen their impact.
Anteromedial Temporal Lobectomy
Selective Amygdalohippocampectomy
Electrocorticography guided Resections
Multiple Subpial transections
Quadrantic Resections
Multilobar Resections
Functional Hemispherotomy
Vagal Nerve stimulation
Radiosurgery (selected cases)
Selective Amygdalohippocampectomy
Electrocorticography guided Resections
Multiple Subpial transections
Quadrantic Resections
Multilobar Resections
Functional Hemispherotomy
Vagal Nerve stimulation
Radiosurgery (selected cases)
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