Dr. Dilip S. Kiyawat, Leading Spine & Neurosurgeon in the Field of Epilepsy Surgery
Epilepsy Surgery
Epilepsy is a neurological disorder characterized by recurrent seizures. Most of the seizures are controlled with anti-epileptic medications. Epilepsy surgery is considered when medications fail to control seizures adequately. The most common surgical option is resective surgery, where the epileptic focus (the area generating seizures) is removed or disconnected from the rest of the brain.
Before surgery, comprehensive evaluations, including neuroimaging (MRI, PET Scan), electroencephalogram (EEG) monitoring, and video EEG help identify the seizure focus and assess candidacy for surgery. Risks and benefits are thoroughly discussed with the patient. During the surgery, the epileptic focus is identified and excised taking the most precautions to preserve the
normal brain tissues.
While surgery can offer significant seizure reduction or even complete seizure freedom, outcomes vary. Most of them experience improved quality of life, while others may need ongoing medication management.
Epilepsy surgery is typically considered for cases where the benefits outweigh potential risks, and it is crucial to involve a multidisciplinary team, including neurologists, neurosurgeons, epileptologists, radiologists, neuropsychologists, and social workers.
Genetic Factors
Some types of epilepsy have a genetic basis, meaning they run in families.
Brain Injuries or Trauma
Head injuries, such as trauma during birth, car accidents, falls, or other traumatic events, can lead to changes in brain function and increase the risk of epilepsy.
Brain Tumors and Lesions
Abnormal growths or lesions in the brain can affect normal neural activity and potentially trigger seizures.
Infections
Certain infections of the central nervous system, such as meningitis, encephalitis, or brain abscesses, can cause inflammation and scarring that may lead to epilepsy.
Epilepsy Surgery
Loss of Consciousness
Many seizures present with a loss of consciousness while others manifest as altered awareness, muscle jerking, or unusual sensations.
Stroke
A stroke, which can result in disrupted blood flow to the brain, may increase the risk of epilepsy. Seizures appearing for the first time in an elderly person are mostly due to stroke or tumor
Metabolic Disorders
Imbalances in electrolytes, blood sugar, or other metabolic factors can potentially trigger seizures.
Neurovascular Diseases
Conditions affecting the blood vessels in the brain, such as arteriovenous malformations (AVMs), may contribute to the development of epilepsy.
Quality of Life
Successful epilepsy surgery can greatly improve the quality of life for individuals by reducing or eliminating seizures and the need for ongoing medicationsi is eliminated.
Developmental Disorders
Conditions that affect brain development, such as neurofibromatosis, tuberous sclerosis, or Down syndrome, may be associated with an increased risk of epilepsy.
Perinatal Injuries
Oxygen deprivation or other injuries during childbirth may increase the risk of epilepsy later in life.
illutrative case of a successful epilepsy Surgery
32-year-old male got his first fit during childhood. He was helping his father in his jewelry shop but was not given financial responsibilities due to frequent fits and poor cognitive functions. He also got married but did not take much responsibilities at home. He was investigated by our team and was detected to have a focus of an epileptic area in his brain on EEG and MRI. During the surgery, Dr Dilip Kiyawat identified the abnormal area and removed it with the help of Microsurgery. The results were dramatic. Not only he was free from fits he also showed improvement in his cognitive functions, memory, and concentration. He was a changed person according to his family and relatives. He was now able to look after his father’s business independently and also took business-related trips to
Such improved cognition after epilepsy surgery has been documented in many patients and is explained based on the control of the fit and the spread of abnormal electrical discharges which otherwise would suppress the functions of the surrounding brain.