Epilepsy is a type of disorder that affects the nervous system. It is characterized by seizures ranging from mild or episodic loss of attention to severe convulsions and loss of consciousness.
At least 30 percent of people who suffer from epilepsy have medically intractable seizures, which means seizures will re-occur despite receiving three or more types of antiepileptic drugs. For patients with seizures that are not controlled with medication, surgical procedures may be a viable option. This procedure either isolates or removes the area of the brain where seizures originate.
Epilepsy surgery candidates are advised to undergo extensive diagnostic tests, which can help locate the origin of their seizures. Tests also ensure that the removal of the brain’s section will not affect their mobility, speech and quality of life.
Current Procedures for the Surgical Treatment of Epilepsy
Neurosurgeons have been working on advanced surgical techniques for individuals with severe cases of epilepsy. Although these technique have been used only for a few years, further studies have proven their effectiveness and safety. The following are some of the latest surgical procedures that aim to treat severe epilepsy.
1. Multiple Hippocampal Transection (MHT)
MHT is done on a portion of the brain that is associated with language and memory. It aims to block epileptic circuits and control seizures effectively. In a study performed by medical researchers at the University of Nebraska Medical Center, 15 patients who have undergone MHT (ages 25 to 60) were monitored after the procedure. Their condition was followed up for about two years after they have undergone surgery. Fourteen of these patients became completely free of seizures after the procedure, while one patient only had an occasional seizure. Most Importantly, these patients’ verbal abilities and memory were not impacted negatively.
2. Laser Treatment for Epilepsy
Medical specialists at the Dell Children’s Medical Center in Central Texas performed an advanced procedure that has helped patients recover from their condition in a matter of days. Disturbing brain sections that affect motor or language skills are serious risks with epilepsy surgery, so doctors aim to minimize this problem by applying a minimally invasive treatment option that uses a laser.
In this procedure, a very slim probe is passed through any abnormal areas in the brain without affecting other regions. By using a laser, it is easy to ablate or remove abnormal tissues while leaving everything else around it. Moreover, patients are able to recover quickly because of this less invasive procedure for epileptic patients.
3. Hippocampal Transection (HT)
Hippocampal Transection has been developed to treat patients who suffer from medically intractable mesial temporal lobe epilepsy or MTLE. However, for patients without sclerosis or hippocampal atrophy, standard surgical procedures such as amygdalohippocampectomy is often linked with decreased postoperative memory functions. Thus, medical specialists have developed the hippocampal transection to address this problem.
The procedure does not involve the removal of the hippocampus. Instead, hippocampal circuits of various epileptic activities are disrupted by a transection of the hippocampus layer. Present clinical studies describe the Transsylvian HT, which is a less invasive and more advanced modification of the HT. Based on research, favorable outcomes were attained with the implementation of the transsylvian HT for patients suffering from MTLE without sclerosis.
In the past decade, epilepsy surgery has been recognized as an effective treatment for patients with medically refractory seizures. With current technologies and innovations in the surgical treatment of epilepsy, patients can recover faster and improve the quality of their life. If you or your loved ones suffer from severe epilepsy, make it a point to consult a reputable neurosurgeon Houston specialist who can offer the best treatment option for your condition.
Dr. Imran Fayaz MD MSc FRCSC FACS P.A.Neurological Surgeon. Diplomate, American Board of Neurological Surgery, Fellow, American College of Surgeons, Fellow, Royal College of Physicians and Surgeons of Canada. Dr. Fayaz has been in practice for twenty years, a communicator, both with his patients and with the referring physicians. He believes that his patients deserve an accurate diagnosis and a realistic treatment and recovery plan.