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Epilepsy Treatment

Neurosurgery in India has progressed by leaps and bounds in the last few decades. Neurology hospitals in India offer the most advanced technology, have surgeons counted among the top neurosurgeons in the world, hospitals that are JCI accredited, English speaking medical staff and results of Epilepsy surgery in India speak volumes for themselves. The best part is that epilepsy treatment and epilepsy surgery in India is available at much affordable cost.

Overview

Epilepsy is the name of a group of disorders of the brain characterized by recurrent episodes of seizures or fits. In simple words, it is a problem with the brain's electrical system. Seizures occur because of disrupted brain activity giving rise to sensorimotor changes, or changes in movement, behaviour, feeling or awareness. Seizures in epilepsy may last for few seconds to a few minutes. They can commence at any age but it usually start in age group between 5-20 years. People who have had two or more seizures without known triggers at a gap of at least 24 hours are considered to be suffering from Epilepsy.

Epilepsy surgery is the most promising treatment that provides freedom from seizures in patients with persistent seizures despite of requisite trials of at least 2-3 antiepileptic drugs.

Overview

Epilepsy occurs as a consequence of permanent changes in the brain either due to some medical disorder or injury to the brain.

The most common known causes of epilepsy include:

  • Traumatic brain injury
  • Stroke or transient ischemic attack
  • Loss of brain function, dementia
  • Congenital brain disorder that is the brain disorders present from birth
  • Brain tumours
  • Cerebral infections including meningitis, encephalitis, brain abscess
  • Abnormal blood vessels in the brain
  • Metabolic disorders like phenylketonuria
  • Bleeding or haemorrhage of the brain

Treatment options

The treatment options for epilepsy include:

Medication:

Anticonvulsant or anti epileptic drugs are the most common treatment for epilepsy. If one medication is not successful in controlling seizures, the doctors switch drugs or adjust the dosage. About two- thirds of people with epilepsy become free of seizures with prescribed medication.

Surgery:

If your doctors can determine that your seizures always begin in a single area of the brain, removing that part of the brain can stop them or make seizures easier to manage. Surgery can also treat conditions that cause seizures, such as brain tumour. The procedures included in this approach are:

The procedures included in this approach are:

  • Temporal lobe resection surgery: This surgery is performed more commonly. In this the anterior and the middle portion of the temporal lobe, which is most often responsible for causing seizures is resected or removed.
  • Functional Hemispherectomy: This is rare but most successful surgery which is performed in most of the widespread and fatal epilepsies. This surgery aims in removing almost an entire half of the cortex (brain) to eliminate the seizures completely.

Palliative:

This approach is opted when there is no definite lesion identified. The aim for this procedure is to reduce the frequency and severity of the seizures by disrupting the nerve pathways that propagates the seizure.

Following procedures are performed in palliative treatment:

  • Corpus callosotomy: It is a surgical procedure performed to reduce the frequency and severity of mostly the generalised seizure or primary atonic (drop attacks) seizure by simply disrupting or cutting the fibres of the corpus callosum which serve a pathway for conduction of the seizure impulse between the two halves of the brain.
  • Multiple subpial transections: This surgical procedure is indicated when the centre of seizure is well localized but cannot be removed or resected as it is located in the vital area of the brain that is involved in speech production, memory and sensorimotor tasks. In such case, the surgeon cuts the nerve fibres in the outer layer of the brain and preserves the deeper fibres that control the vital neurologic function.
  • Vagus nerve stimulation: It is a palliative procedure for the patient with partial or generalized seizures. During this procedure, the vagus nerve stimulator is implanted under the skin of the chest which electrically stimulates the vagus nerve periodically. These signals are then transmitted from the vagus nerve to part of brain expected to be involved in producing seizures resulting in subsequent decrease in frequency and severity of the seizures.