July 31, 2010      


Epilepsy Surgery



Epilepsy Surgery is applicable in patients who do not respond to medication or are reactive to drugs with severe side effects. In 30% of epileptics, seizures cannot be controlled by drugs, hence affecting their normal lives.

However, surgery is possible only if the brain site where the seizures starts can be clearly detected and if the site does not have any vital operations like speech, consciousness, memory, movement etc. Surgery is considered applicable only after through examination and screening.



Types of Epilepsy Surgery

There are two broad categories of surgery. The first removes the part of the brain that causes seizures and the second cuts short the nerve channels through which seizure pulses extend through the brain.

Moreover, the type of surgery is also determined by the kind of seizures and the region of the brain where the seizures starts. Clinically some of the surgical procedures are as follows:

Lobe resection of the cerebrum of the brain
Lesionectomy that removes isolated brain lesions
Corpus callosotomy on the corpus callosum of the brain
Functional hemispherectomy on one half of the brain
Multiple subpial transection (MST) of the brain tissues


Complications of Epilepsy Surgery

Common complications include:

Infection and bleeding
Allergic reaction to the anesthesia
Neurological problems after surgery
Surgery failure that may even require re-operations


Recovery and Post Operative Care

Anti-seizure medication is usually prescribed for around two years after surgery, which is reduced or stopped once seizure is controlled. It takes about 3 to 8 weeks to get back to normal life. Driving is the only major restriction for at least a year. If there are any neurological problems after surgery or memory problems, speech or physical therapy is required.


Effectiveness

Though it is the last line of therapy, epilepsy surgery is generally safe and effective, though it is dependent on the type of surgery. However, it cannot be conducted on patients with other serious ailments like cancer or heart diseases.

   

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