Is surgery the right option for epilepsy management?

Epilepsy surgery is an option for people with epilepsy who have not been able to get their seizures under control with medication. Epilepsy surgery is usually done by a neurosurgeon, a doctor who specializes in surgery on the nervous system.

The goal of epilepsy surgery is to remove as much of the seizure focus as possible. This involves removing the part of your brain where the seizures start. Most often, the temporal lobe is removed in a procedure known as temporal lobectomy. In some cases, this can stop seizure activity.

In some cases, you’ll be kept awake during this surgery so doctors can talk with you and avoid removing part of the brain that controls important functions such as vision, hearing, speech, or movement. But before understanding whether is surgery the right option for epilepsy management, let us first know what epilepsy is, its causes, symptoms, possible treatment, and need for surgery.

What causes epilepsy?

Epilepsy is a chronic neurological disorder that causes recurrent, unprovoked seizures. A seizure is a sudden, uncontrolled electrical disturbance in the brain. Epilepsy can cause changes in your behavior, sensations, and sometimes, loss of consciousness. In about half of people with epilepsy Trusted Source, the cause cannot be determined, per the WHO. A variety of factors can contribute to the development of seizures, such as:

  • traumatic brain injury or other head trauma
  • brain scarring after a brain injury (post-traumatic epilepsy)
  • serious illness or very high fever
  • stroke, which causes about half of trusted sources of epilepsy cases in older adults when there’s no identifiable cause, according to the CDC
  • lack of oxygen to the brain
  • brain tumor or cyst
  • dementia, including Alzheimer’s disease
  • maternal use of some drugs, prenatal injury, brain malformation, or lack of oxygen at birth
  • infectious conditions like HIV and AIDS and meningitis
  • genetic or developmental disorders or neurological diseases

Epilepsy can develop at any age, but diagnosis usually occurs in early childhood or after 60 years.

Is epilepsy hereditary?

Epilepsy can run in families, but most people with epilepsy don’t have a family history of the condition. In fact, only about 5 percent of people with epilepsy have a family member with the disorder. Epilepsy that’s caused by a genetic mutation is called familial epilepsy or inherited Epilepsy.

Most people with epilepsy have seizures that cause physical shaking or convulsions. But not all types of seizures involve convulsions. There are different types of seizures, which may include:

generalized tonic-clonic seizure (formerly called grand mal seizure) – This type of seizure involves a loss of consciousness and body stiffening followed by jerking motions.

partial seizure (also called focal seizure) – This type of seizure is characterized by repetitive movements, such as lip-smacking, twitching, and head nodding. People usually remain aware during a partial seizure.

absence seizure (formerly called petit mal seizure) – This type mostly affects children and is characterized by.

What triggers an epileptic seizure?

There’s no one answer to this question. Epileptic seizures can be triggered by a variety of things, including:

  1. lack of sleep
  2. missed medication doses
  3. alcohol or drug abuse
  4. flickering lights
  5. stress
  6. certain medical conditions, such as low blood sugar, fever, or infection

For some people with epilepsy, there are no known triggers. In other cases, people may only have seizures when they’re exposed to certain triggers. Epilepsy that’s caused by an environmental trigger is called reflex epilepsy.

Some common triggers include:

  1. flashing lights (photosensitive epilepsy)
  2. specific patterns (pattern-sensitive epilepsy)
  3. skipping meals (hunger)

Identifying triggers isn’t always easy. A single incident doesn’t always mean something is a trigger. Often, a combination of factors triggers a seizure.

A good way to find your triggers is to keep a seizure journal. After each seizure, note the following:

  • day and time
  • what activity you were involved in
  • what was happening around you
  • unusual sights, smells, or sounds
  • unusual stressors
  • what you were eating or how long it had been since you’d eaten
  • your level of fatigue and how well you slept the night before

You can also use your seizure journal to determine if your medications are working. Note how you felt just before and just after your seizure, and any side effects.

Bring the journal with you when you visit the doctor. It may be useful for your doctor if adjusting your medications or exploring other treatments is, or becomes, necessary.

Potential complications of epilepsy

Epilepsy can lead to a number of complications, some of which are serious. These include:

Sudden death: Epilepsy itself doesn’t directly cause death, but having seizures can put you at risk for accidents and injuries that may be fatal. According to the Epilepsy Foundation, sudden unexpected death is the most common. A few more cases can be:

  • Status epilepticus: This is a life-threatening condition that’s characterized by seizure activity that lasts for more than five minutes or seizures that occur close together and the person doesn’t recover between them.
  • Pregnancy complications: Epilepsy can pose risks for both the mother and the developing baby. These risks can be reduced with proper planning and treatment.
  • Mental health problems: Epilepsy can lead to depression, anxiety, and other mental health disorders.
  • Can surgery help cure epilepsy?
  • Surgery isn’t a cure-all for epilepsy, but it can be an effective treatment option for some people with the condition.

How is epilepsy diagnosed?

If you think you or your child may have epilepsy, make an appointment with a doctor. Epilepsy is often diagnosed after a person has had more than one seizure that can’t be attributed to another condition.

In order to diagnose epilepsy, the doctor will likely:

  1. ask about your medical history and that of your family
  2. conduct a physical exam
  3. order blood tests
  4. administer an electroencephalogram (EEG)
  5. request brains imaging tests, such as MRI or CT scan

Your doctor may also refer you to a neurologist or epileptologist for further testing. These are doctors who specialize in diagnosing and treating neurological conditions like epilepsy.

After all the testing is complete, the doctor will work with you if you suspect you’ve had a seizure, see a doctor as soon as possible. A seizure can be a symptom of a serious medical issue.

How is epilepsy treated?

Epilepsy can’t be cured, but there are treatments that can help control seizures. The type of treatment you receive will depend on the severity and frequency of your seizures, as well as any underlying medical conditions.

Some people with epilepsy only require medication to manage their condition. Others may need surgery. In some cases, a combination of medication and surgery is necessary.

The goal of treatment is to minimize the number and severity of seizures while still allowing you to live a normal life.

Medications

Anti-seizure medications are the most common form of treatment for epilepsy. These drugs don’t cure epilepsy, but they can help prevent or reduce the number of seizures you have.

  • Your medical doctor will work with anti-epileptic (anticonvulsant, antiseizure) drugs. Anti-epileptic medicines can assist lessen the range of seizures you have. In a few people, they will take away seizures. To be most effective, the medicine should be taken precisely as your medical doctor prescribed.
  • Vagus nerve stimulator. This tool is surgically located beneath neath the pores and skin of your chest and electrically stimulates the nerve that runs through your neck to prevent seizures. Ketogenic diet. According to the Epilepsy Foundation, more than 1/2 of youngsters who do now no longer reply to medicines enjoy the ketogenic diet, which is an excessive fat and a low carbohydrate diet.
  • Brain surgery. The region of the mind that reasons seizure activity may be eliminated or altered in case you and your healthcare team decide it’s the proper remedy for your condition.

Surgery for epilepsy

In some cases, surgery may be an option to treat epilepsy. Epilepsy surgery is usually only considered if:

  1. medications are not working or cause serious side effects
  1. the person has a single focus of seizure activity in the brain that can be removed without affecting important mental functions
  2. Epilepsy surgery is very effective
  3. If medication can’t decrease your number of seizures, another option is brain surgery.

The brain is enigmatic in ways of its structure and function. Epilepsy and movement disorders essentially affect the quality of life in otherwise normal individuals. We at Nanavati Max Hospitals, Mumbai, India have a robust team of experts to take care of such issues.

As a core member of the team, Dr. Sonal Jain is a functional neurosurgeon trained in Epilepsy in India and USA and is one of the best Epilepsy surgery experts in Mumbai. There is no other neurosurgeon in the city of Mumbai trained hands-on in the USA for Epilepsy surgery like Dr. Sonal Jain.

Dr. Sonal Jain has been working with Epilepsy patients for more than a decade now and has helped many get their life back on track. Epilepsy surgery is very effective and can help you lead a normal life.

If you or your loved ones are suffering from Epilepsy, please do not hesitate to reach out to us.

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