Advanced Epilepsy Treatment Options in India - Epilepsy Surgery in India

Epilepsy Surgery

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

Candidates for Epilepsy Surgery

It is very important that right candidates be chosen for the best results of the surgery. You are a good candidate for epilepsy surgery if:

• You have tried at least two anti-epileptic drugs (AEDs), and they have not stopped, or greatly reduced the number of seizures.
• There must be a specific cause for your epilepsy that can be removed with surgery, without harming your brain or you in any other way.
• Your surgeon must weigh the pros and cons and is confident that you would have a better quality of life after the surgery than without it.

Advanced EpilepsyTreatment Options in India

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)

Epilepsy Surgery inIndia

Epilepsy is one of the most common neurologic diseases, present in about 4% of the world's population. The disease can be well controlled with medications alone, but many patients do not respond well to the epileptic medications and thus need surgery to control seizures.Epilepsy surgery is advised to people who have tried at least two epilepsy drugs without success and have seizures originating on the same place of the brain.

Epilepsy surgery removes or isolates the area of brain where seizures originate. If it is an area of the brain which cannot be removed, the surgeon makes incisions to prevent seizures from spreading to other parts of the brain.