Aster Epilepsy Centre

Epilepsy surgeries are of two types. In patients where we find a small, focal brain area responsible for epilepsy, we go for resection of that area. These surgeries are called curative surgeries where once that area is removed; patient will be mostly free of epilepsy. However, there is a group of patients in which a large area is responsible, or we could not define a small area or removing complete area is not feasible; surgeries are meant to just reduce seizure frequency and improve quality of life. These surgeries are called palliative surgeries.

Epilepsy surgery is a carefully planned procedure, carried out under optimal circumstances to remove the region of brain causing the seizures, and to spare parts of the brain necessary for everyday functions.
Complications are very infrequent in epilepsy surgery, major complications like motor deficits, language deficits, vegetative states and disabilities are seen in 3-5% of cases. Other treatable complications like infections, prolonged hospitalizations, transient deficits, speech problems, mood problems, visual field deficits are common and do not alter the normal daily life. Overall, epilepsy surgery is safe surgery, and it improves quality of life of many patients and their care takers significantly.
 

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.

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.

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.

A Seizure is a condition in which sudden, uncontrolled electrical irregularity occurs in our brain. It may cause changes in behaviour, movements or feelings, and levels of consciousness.

Usually, a seizure may last from a few seconds to a few minutes, based on the type of seizure.

Not always. Seizures can also happen because of other medical problems.

These problems include:

• A high fever.
• Low blood sugar.
• Alcohol or drug withdrawal.

A provider and person with epilepsy can do several things to stop or lessen seizures.

The most common treatments for epilepsy are:

• Medicine: Anti-seizure drugs are medicines that limit the spread of seizures in the brain. A health care provider will change the amount of medicine or prescribe a new drug if needed to find the best treatment plan. Medicines act for around 2 in 3 people with epilepsy.
• Surgery: When seizures arise from a single area of the brain (focal seizures), the surgery to exclude that area may stop future seizures or make them easier to manage with medicine. Epilepsy surgery is mostly used when the seizure focus is located in the temporal lobe of the brain.
• Other treatments: When medicines fail to work and surgery is not possible, then other treatments can help. It includes vagus nerve stimulation in which an electrical device is placed or implanted, under the skin on the upper chest to transfer signals to a large nerve in the neck. Another option is the ketogenic diet, high fat and low carbohydrate diet with restricted calories.

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.