1. What are the different types of epilepsy surgeries?
Epilepsy surgeries are mainly of two types. In patients where we find a small, focal brain area accountable for epilepsy. We go for resection of that area. These surgeries are called curative surgeries where once that area is excluded; the 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.
2. What are the chances of improvement after epilepsy surgery?
Chances of seizure control depend on many variables and range between 50-90%. If MRI shows some lesion that could be completely removed, then 9 out of 10 people can achieve seizure freedom, and almost 6 out of 10 patients can be off the medicine. However, the outcome is in the magnitude of 50% with palliative surgeries. The outcome typically depends on the responsible pathology.
3. What are complications with epilepsy surgery?
Epilepsy surgery is a carefully planned method, carried out under optimal conditions to remove the region of the 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, improves the quality of life of many patients and their caretakers significantly. Seek medical help from the Best Epilepsy Specialist in Bangalore and get personalized advice.
4. Do I need to take anti-epileptic medications post-surgery?
We recommend continuing the medication for at least two years, subsequent to which medications can be reduced and even stopped in certain cases where the seizures are well controlled.
5. What is Epileptology and what is the role of epileptologist?
Epileptology is a subspecialty of Neurology, focusing on the 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, pediatrician, or Neurologist.
Epileptologist is trained in detailed evaluation and management of complex pediatric as well as adult epilepsy cases and plays the main role in precisely finding out whether there is an epileptogenic focus in the brain which can be surgically removed to permanently cure epilepsy.
6. 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.
7. What is the incidence of epilepsy and drug-resistant epilepsy?
There are about 70 million people with epilepsy (PWE) around worldwide, nearly 12 million PWE are expected to live in India; which contributes to nearly one-sixth of the global burden. One million Indians have medically refractory seizures. Approximately about 5 -6 lakh peopleare candidates who need epilepsy surgery in India.
8. 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.
9. 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 brains. So, if we can surgically remove the abnormality which is visible on the MRI brain, we can practically cure epilepsy and improve the quality of life of the person affected with epilepsy.
10. 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
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.
If you are looking for Best Epileptology Treatment in Bangalore, get in touch with Aster RV Hospital, JP Nagar.