Epilepsy surgery

Epilepsy Surgery refers to the procedure that removes an area of the brain where seizures occur. It is most effective when seizures always occur in a single location, also known as Focal seizures, in the brain. Although it is not the first line of treatment but is considered when at least two anti-seizure medications have failed to control seizures.

The surgery is necessarily an option when the patient has a condition known as medically refractory epilepsy or drug-resistant epilepsy, which prevents medication to control the seizures. The goal of the surgery is to stop seizures or limit their severity with or without the use of medication.

Poorly controlled epilepsy can result in a number of complications including:

• Physical injuries during a seizure

• Drowning, if the seizure occurs during a bath or swimming

• Depression and anxiety

• Developmental delays in children

• Sudden death, a rare complication of epilepsy

• Worsening memory or other thinking skills

TYPE OF SURGERY

The type of surgery depends on the location of the neurons that start the seizure and the age of the patient:

1. Resective surgery: This is the most common type of surgery that involves removing a small portion of the brain. The surgeon basically cuts out brain tissues in the area of the brain where seizures occur, usually the site of a tumour or malformation. It is usually performed on one of the temporal lobe which is the area that controls visual memory, language comprehension and emotions.

2. Laser interstitial thermal therapy (LITT): This is a less invasive surgery that utilises laser to pinpoint and eradicate a small portion of brain tissue. It makes the use of Magnetic Resonance Imaging, aka, MRI to guide the laser that the surgeon uses.

3. Deep brain stimulation is the use of a device: It involves a permanently implanted device, deep in the brain, to release regularly timed electric signs that disrupt abnormal, seizures-inducing activity. This procedure is also guided by MRI. The generator sending the electric pulse is implanted in the chest.

4. Corpus callosotomy: This surgery involves complete or partial removal of a part of the brain that connects nerves on the right and left sides of the brain. This is generally used with children who experience abnormal brain activity that spreads from one side of the brain to the other.

5. Hemispherectomy: This procedure removes one side (hemisphere) of the folded gray matter of the brain (cerebral cortex). This surgery is generally reserved for children who experience seizures that originated from multiple sites in one hemisphere, as a result of a condition present at birth or in early infancy.

6. Functional hemispherectomy: This too is primarily used in children and removes the connection nerves without removing actual pieces of the brain.

A senior neurosurgeon of international repute with excellent management skills and one of the Best Neurosurgeons in Kolkata, Dr. Kaushik Sil has over 16 years of experience in treating complex Brain and Spine problems like brain tumours, spinal disc prolapse, brain stroke, subdural hematoma, spinal deformity with a special interest in childhood neurosurgical problems like hydrocephalus and spinal birth defects. His simple guidance and high success in treatment rates is immaculate.