What are EEG and video EEG and their necessity?
Video EEG is nothing but a simultaneous recording of EEG along with a video camera focused on you all the time. You will be admitted, and EEG leads will be connected to you. You will be under the camera for 24 hours while your EEG on. When you have a seizure, it will record the exact movements you do during your seizure activity and simultaneous EEG recordings. This will provide us with the exact idea of the area of your brain accountable for producing these seizures. Generally, 3-10 episodes of seizure will be recorded and so patients usually stay for 5-7 days in the hospital. We generally stop your drugs so that more seizures can be obtained in a short time. It is secure as you are having seizures in a controlled environment of the hospital, supported with doctors and nurses all the time.
What is an Epilepsy Monitoring Unit (EMU?)
It is a specialized unit in the hospital for constant monitoring of brain activity using EEG and Video, where a patient is admitted for 3-5 days. This provides your doctor with a better understanding of your seizures by seeing how your brain functions and what you are physically doing during the event.
Why should patients with intractable seizures undergo epilepsy surgery?
If your seizures are managed with one or two drugs, then surgery is not needed. However, when you have to take more than two medications and you continue to have seizures, surgery is a rational choice due to the problems associated with recurrent seizures such as:
• Poor quality of life
• Injuries
• Social ostracism
• Marital issues
• Care-giver burden
• Adverse effects of medication
• Sudden unexpected death
Even financially, if you are on two medications, your monthly maintenance comes to around 5000/ month i.e., Rs.60,000 annually. The average cost of epilepsy surgery with all investigations, hospitalization is close to 2.5-3 lakhs.
What is epilepsy surgery and when is it recommended?
In 20-30% of patients diagnosed to be having epilepsy, drugs cannot control epilepsy. Most of the time, these patients have something visibly abnormal in their brain. So, if we can surgically remove the abnormality which is visible on MRI brain, we can practically cure epilepsy and improve the quality of life of the person affected with epilepsy.
What are the investigations required for a patient with drug-resistant epilepsy?
Basic tests include Video EEG, 3 Tesla MRI epilepsy protocol and Neuropsychological assessment. Additional tests needed may be PET scan, SPECT scan, functional MRI, WADA.
What is the incidence of epilepsy and drug-resistant epilepsy?
There are 70 million persons with epilepsy (PWE) worldwide, nearly 12 million PWE are expected to reside in India, which contributes to nearly one-sixth of the global burden. One million Indians have medically refractory seizures. An approximate 5 -6 lakh people are candidates for epilepsy surgery in India.
What is drug-resistant epilepsy/ intractable seizures?
It is defined as the failure of enough trials of two tolerated, properly chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom.
What is Epileptology and what is the role of epileptologist?
Epileptology is a subspecialty of Neurology, focussing on evaluation and management of difficult to treat or complex epilepsy cases where seizures were not controlled despite starting anti-epileptic medications prescribed by a physician, paediatrician, or Neurologist.
Epileptologist is trained in detailed evaluation and management of complex paediatric as well as adult epilepsy cases and plays the key role in precisely finding out whether there is an epileptogenic focus in the brain which can be surgically removed to permanently cure epilepsy.
How can I prevent epilepsy?
Sometimes we can prevent epilepsy. The most common ways to reduce your risk of developing epilepsy are: Have a healthy pregnancy. Some problems during pregnancy and childbirth may lead to epilepsy. Follow a prenatal care plan with your healthcare provider to keep you and your baby healthy. Prevent head injuries Lower the chances of stroke and heart disease. Be up to date on your vaccinations. Wash your hands and prepare food safely to prevent worm infections such as cysticercosis
What can I do to manage my epilepsy?
Self-management is what one should do to take care of self. You can learn how to manage seizures and keep an active and full life. Begin with these tips: Take your medicine. Discuss with your doctor or nurse when you have questions. Recognize seizure triggers (such as flashing or bright lights). Keep a record of your seizures. Get enough sleep. Lower stress.
