At KD Hospital, our expert team of Epileptologists and Neurosurgeons are specialised in advanced epilepsy management. Using cutting-edge technology, we offer comprehensive epilepsy treatment tailored to each patient's unique needs. Our multidisciplinary approach ensures precise diagnosis and effective surgical interventions, leading to optimal outcomes. Choose KD Hospital for the best epilepsy surgery, offering hope and healing through expert treatment and innovative surgical techniques.
Epilepsy is the second most common and frequently encountered neurological condition that imposes a heavy burden on individuals, families, and also on healthcare systems. As per a recent study, 70 million people have epilepsy worldwide, and there are more than 12 million persons with epilepsy (PWE) in India, which contributes to nearly one-sixth of the global burden.
Epilepsy surgery is a procedure that removes an area of the brain where seizures occur. Epilepsy surgery is most effective when seizures always originate in a single location in the brain. Epilepsy surgery is not the first line of treatment. But it might be an option when at least two anti-seizure medicines have failed to control seizures.
Kids born with single/multiple epileptic focus suffer from a very high frequency of seizures, which can easily be missed unless it is classical generalised epilepsy. These kids are the least likely to benefit from any combination of medicines. Early surgery improves the quality of life as well as the cognitive and developmental outcomes of the child. For children with "surgically remedial epilepsy”, surgery should be offered as a procedure of choice rather than as a treatment of last resort. Even major resective surgeries can be done with minimal long-term deficits due to excellent plasticity of the brain, which is most remarkable up to five years of age. At KD Hospital, we have successfully done surgery for a 6-month-old child.
Once it has been established that the patient’s seizures are not controllable, he/she undergoes a series of investigations to establish the root cause. The epileptologist does a detailed study of Video EEG, which has huge data of up to 100 hours or more. Each case is analysed in detail at weekly MDT (Multi-Disciplinary Team) meetings to assess the necessary feasibility, risk analysis and outcome prediction. Once the surgical plan is established a series of meetings with the patient and family are carried out to discuss all the pros and cons of surgery and medical management. The patient undergoes surgery only if there is a mutual concussion between the family and the Epilepsy Team.
Epileptic seizures result from irregular activity of brain cells called neurons. The type of surgery needed depends on the location of the neurons that start the seizure and the age of the person having the surgery.
Types of surgery include:
Resective Surgery is the most common epilepsy surgery. It involves the removal of a small portion of the brain. Under the microscope, the surgeon cuts out brain tissue from the area of the brain where seizures occur. This is usually the site of a tumour, brain injury or malformation. Resective surgery is most commonly performed on one of the temporal lobes. This is an area of the brain which controls visual memory, language comprehension and emotions.
Laser Interstitial Thermal Therapy (LITT) is less invasive than resective surgery. It uses a laser to pinpoint and destroy a small portion of brain tissue. Magnetic resonance imaging (MRI) is used to guide the laser.
Deep Brain Stimulation (DBS) is the use of a device that is placed permanently deep inside the brain. The device releases regularly timed electrical signals that disrupt seizure-inducing activity. This procedure is guided by MRI. The generator that sends the electrical pulse is implanted in the chest.
Corpus Callosotomy is surgery to completely or partially splits the part of the brain that connects nerves on the right and left sides of the brain. This part of the brain is called the corpus callosum. This surgery is usually used with children who experience irregular brain activity that spreads from one side of the brain to the other, leading to drop attacks.
Hemispherectomy is a procedure to remove one side of the damaged brain tissue called the cerebral cortex. This surgery is generally done only in children who experience seizures that originate from multiple sites in one hemisphere, usually the result of a condition present at birth or in early infancy.
Functional Hemispherotomy is a procedure primarily used in children that precisely disconnects the abnormal and seizure-producing verses from the normal counterpart without actually removing the brain tissue.
Vagus Nerve Stimulation (VNS) device involves placing electrical lead wires around the vagus nerve in the neck. The vagus nerve starts in the lower area of your brain and travels down to your abdomen. A small, matchbox-sized pulse generator is implanted below the collarbone. The pulse generator sends scheduled mild electrical pulses to your brain to disrupt any abnormal bursts that happen during a seizure. This is especially useful in people who aren’t candidates for other types of surgery or when the surgery didn’t work.
MD (General Medicine), DM(Neurology), PDF Epilepsy
Senior Consultant Neurosurgeon
DM (Neurology), DNB (General Medicine), MNAMS, PDF Epilepsy
