Epilepsy
Epilepsy is a non-communicable, neurological condition characterised by tremors or recurrent, unprovoked seizures because of surges of electrical activity in the brain. Seizures are the brief involuntary body movements of part of the body (partial) or whole body (generalised). These are the result of excessive electrical discharges in a group of brain cells. They can vary from shortest lapses of attention or muscle jerks to intense, prolonged convulsions and even in their frequency. Sometimes, they are accompanied by unconsciousness and loss of control of bladder and bowel functions.
Epilepsy does not have a definite cause. It could be caused by a severe head injury, certain genetic syndromes, brain damage due to prenatal or perinatal reasons, birth defects, or genetic conditions characterised by brain malformations, brain tumours, stroke, and infection of the brain. There are many treatment plans for seizures and tremors associated with epilepsy. Among them, only a few are safe, effective, and trusted by neurologists. These are deep brain stimulation, ultrasound therapy and MR-guided focused ultrasound, medications, and surgery.
Arete Hospitals is one of the top-notch Epilepsy, Seizures, and Tremors hospitals in Hyderabad. It has the top-rated departments of neurology and neurosurgery with the leading epilepsy team (epileptologist, neurosurgeon, epilepsy nurse, neuropsychiatrist, and neuropsychologist) and state-of-the-art technology under one roof.
The neuro-specialists at Arete Hospitals deliver unparalleled quality, personalised care, and hospital experience to their patients. They have proven clinical experience in handling even the most serious cases precisely and accurately.
Benefits of Epilepsy Surgery
Epilepsy surgery is an operation of the brain to stop or reduce the frequency/numbers/severity of seizures that an epilepsy patient experiences.
Surgical treatment of epilepsy in Hyderabad performed on epilepsy patients can help them experience few seizures, less severe seizures, or stop having them completely. Even if they aren’t seizure-free, they can still benefit from:
A lower dose or number of medications for seizures and tremors needs to be taken, which can even minimise medications’ side effects. To get more details contact Best Doctors For Tremors Treatment in Hyderabad at Arete Hospitals.
- Greater chances of a quick recovery and resuming work and driving.
- Fewer life-threatening complications such as status epilepticus or sudden unexplained death in epilepsy.
- Reduced risk of anxiety and depression after a successful surgery.
Other Benefits of Epilepsy Treatment
- Treatment helps to control seizures and aims to reduce or eliminate seizures and enhances daily life
- Enhanced safety of the patient as there are fewer seizures that mean lower risk of accidents or injuries
- Improved Independence as seizure control promotes greater autonomy
- Treatment can help maintain cognitive abilities
- Emotional well-being and reduced seizures contribute to better mental health
- Controlled epilepsy often restores driving eligibility
- Treatment enables a more typical, unrestricted lifestyle.
Signs and Symptoms of Epilepsy
Epilepsy patients usually show the following signs and symptoms of seizures:
- Muscle stiffening
- A staring spell- a period of spacing out, signalling an absence of seizure
- Temporary confusion
- Loss of awareness or getting unconscious
- Uncontrolled jerking of legs and arms
- Psychological issues like fear, déjà vu, or anxiety
- Depending upon which part of the brain activity is being affected, there are different types of seizures. The symptoms of seizures are usually similar in every episode. Besides seizures, epilepsy patients may even experience behavioural changes or symptoms of psychosis. In any such case, patients need epilepsy treatment. An initial consultation with an epileptologist in Hyderabad is needed to diagnose epilepsy and know about its appropriate treatment options.
Treatment Options Offered at Arete Hospitals for Epilepsy
Epilepsy treatment in Hyderabad typically involves a combination of medications, some lifestyle modifications, brain stimulation, and in severe cases, surgical interventions. The patients receive a tailored treatment plan for epilepsy, usually by a neurologist, based on their type of epilepsy, personal medical history, general health status, and severity of seizures. The different treatment approaches for epilepsy include:
- Medications- The primary treatment approach for epilepsy is prescribing the patient anti-epileptic drugs. These medications can help control or lower the frequency and severity of epileptic seizures. There are many anti-epileptic drugs available. The neurologist in Hyderabad will prescribe the patients with specific drugs after looking at certain factors. These include the patient’s age, type of epilepsy, and any other medical conditions as well as potential side effects of the medicine.
- Vagus Nerve Stimulation (VNS) in Hyderabad- It is a surgical option to treat epilepsy in some patients. The procedure involves implanting an electronic device under the chest skin. This device delivers electrical impulses to the vagus nerves, located in the neck area, to stimulate the nerves and reduce the frequency and intensity of seizures.
- Responsive Neurostimulation (RNS)- It is a newer surgical approach to treat epilepsy in Hyderabad by preventing seizures. The procedure involves the implantation of an electronic device in the brain area that monitors the activity of the brain. When this device detects abnormal activity in the brain, it sends small electrical pulses to the brain activity monitoring region to normalise the brain activity.
- Epilepsy Surgery- For epilepsy patients who fail to be treated by anti-epileptic medications, surgery may be an option. The surgery involves the removal of the “seizure focus” portion of the brain known to trigger seizures. This is only performed when the seizure focus is in that part of the brain which can be removed without impairing the functioning of that part of the brain.
- Support and Counseling- As epilepsy can be very impactful on the mental and emotional health of the patient, counselling and attending support groups can help. This way, both epilepsy patients and their families can receive valuable guidance, emotional support, and comprehensive care.
Before Epilepsy Surgery
The epilepsy patient needs to prepare for surgery. Generally, the patient needs to schedule a meeting with an epileptologist and neurosurgeon to get a clear picture of the recommended surgery. The patient needs to talk with an epilepsy nurse to know about pre and post-surgery care and even meet a therapist and psychiatrist to review the support network and share feelings related to surgery.
In the days leading to epilepsy surgery, the patient must:
- Continue to take prescribed seizure and tremor medications regularly.
- Have a healthy diet and keep the body well-hydrated.
- Practise good sleep habits.
- Be active and in the best possible shape to recover quickly and smoothly after the operation.
- Discontinue intake of medications that may increase the risk of bleeding.
- Complete undergoing all tests recommended by the epilepsy team or pre-surgical evaluation team- internists and anesthesiologists.
- Arrange for someone to drive home and care at home after surgery.
What does Epilepsy Surgery Involve?
Epilepsy surgery is carried out under general sedation. Throughout the surgery, the patient is monitored for heart rate, oxygen levels, and blood pressure. An EEG monitoring takes place to record brain waves during operation and better localise the brain part where seizures begin. In some cases, the surgeon creates a relatively small window in the skull and after the surgery, the skull bone is replaced and fastened to the rest of the skull for healing.
Types of Epilepsy Surgeries
- Surgical resection- This involves the removal of the region of the brain where the seizures initiate. Its types are:
- Lesionectomy- It is for the removal of tumours, arteriovenous malformations, and cavernous hemangiomas that can cause seizures.
- Lobectomy- It is done to remove the frontal, parietal, occipital, or temporal lobe in which seizure occurs. The surgery may involve the removal of all lobes or parts of two or more lobes only if vital brain functions of a particular lobe have been affected.
- Hemispherectomy- It involves the removal of half of the brain or the severing of fibres that connect one hemisphere of the brain to another. This usually takes place in case of severe seizures.
Surgical disconnection- This involves cutting off communication between brain nerve cells to avoid spreading seizures to other parts of the brain. It’s of the following types:
- Corpus callosotomy- It is done to disconnect the corpus callosum- the main nerve fibre bundle connecting two hemispheres of the brain.
- Multiple subpial transections- It involves making multiple shallow cuts into limited sections of brain tissue. This is preferred when the seizures affected part of the brain cannot be resected safely.
- Stereotactic radiosurgery- Using 3D computerised imaging, radiation beams are precisely focused on the seizures affected part of the brain to destroy nerve cells causing seizures or tremors.
- Laser interstitial thermal therapy- The neurologist uses a medical-grade laser to heat destroy the nerve cells where the seizure starts. This is helpful if the seizure is located in a small part of the brain which can be accessed using an MRI scan
Neuromodulation (implanting devices)- Without removal of brain tissue, different neuromodulators include:
- Deep brain stimulation- This involves the implantation of a pacemaker-like special device and electrodes that send electrical signals to disrupt or block seizure activity at its source. The electrode is placed in the brain and a stimulator device under the skin in the chest.
- Responsive neurostimulation- It involves placing a device on the surface or deeper within brain tissue where the seizure starts to stop it. It is approved for patients having focal seizures.
Good Candidates for Epilepsy Surgery
- Individuals who cannot control their seizures and tremors with medications and diet therapy.
- Epilepsy patients who experience severe, frequent, and debilitating seizures.
- People whose seizures begin and remain within one area of their brain.
- People who can safely undergo surgery without experiencing any new or additional problems in speech, memory, vision, and movement.
After Discharge
The patient needs to follow recommended post-surgical instructions, including:
- Continue to take anti-seizure medications till the time the doctor prescribes them to keep the brain protected from seizures happening again as it heals. The medication dose will be reduced and when there is no seizure episode for a year or two, the medications no longer need to be taken.
- Take adequate rest.
- Return to normal daily activities in about 4-6 weeks and to work or school in about 1-3 months.
- Take rehabilitation therapies only if the vital functions of the brain have got affected.
Effectiveness of Epilepsy Surgery
The effectiveness or success of epilepsy surgery depends on different factors, including:
- Type of seizures the patient experiences
- The frequency and severity of seizures/tremors
- Type of surgical approach used
- Patient’s age
- Any other existing medical conditions of the patient
- The part of the brain where seizures occur.
Risks Associated with Epilepsy Surgery
The typical risks associated with epilepsy surgery include:
- Bleeding
- Anaesthesia-related risks
- Infection
- Delayed healing at the surgery site
- Damage to brain tissues
- Additionally, epilepsy surgery can affect vital functions of the brain such as speech, memory, vision, and movement depending upon which part of the brain seizure is taking place. That’s why doctors perform pre-surgery testing and mapping of the brain to locate the initiating site of seizure and reduce potential risks.
- Less invasive epilepsy surgeries like stereotactic radiosurgery, laser interstitial thermal therapy, and neuromodulation options like deep brain stimulation, vagus nerve stimulation, and responsive nerve stimulation have minimal risks involved.
- If the epilepsy surgery involves resection of the temporal lobe of the brain, the risks include memory problems, speech difficulties, loss of muscle control, vision problems, and mood issues/depression.
Cost of Epilepsy Treatment in Hyderabad
It depends upon the type of treatment procedure chosen, the doctor’s expertise and experience, patient severity of issue, and other additional factors.
1. What to expect after epilepsy surgery?
It is expected to experience facial and scalp swelling as well as headaches following epilepsy surgery. These side effects are short-lived and treatable with medications. Most patients have a one-day stay in the intensive care unit and a 3-4 days hospital stay.
2. What does pre-surgical testing involve?
Pre-surgical testing is done by an epilepsy doctor in Hyderabad to determine the candidacy of the patient for epilepsy surgery. Phase 1, non-surgical tests include EEG, in-hospital video EEG, PET, SPECT, Wada test, neurophysiological evaluation, and functional MRI. Phase 2, surgical tests involve placing electrodes on the brain surface or within tissues close to where seizures are happening. It includes stereo electroencephalography and functional brain mapping.
3. How can I self-manage epilepsy?
You can manage epilepsy with some lifestyle modifications that complement medication therapy. The lifestyle modifications include sleep, stress management, avoiding triggers of seizures, and having a ketogenic diet. Epilepsy patients must get enough, good-quality sleep on a regular schedule. If there is great stress, epilepsy patients can try becoming stress-free by daily doing meditation, deep breathing exercises, and other stress-relieving techniques. Certain foods, alcohol, and the use of flashlights must be avoided to avoid epileptic seizure episodes. Sometimes, a diet rich in fats and low in carbohydrates (called a ketogenic diet) is recommended for epilepsy patients who fail to respond much to epilepsy medications. Such a diet can help reduce the frequency of seizures in some patients, especially children.
Contact the experts at Arete Hospitals, best epilepsy treatment hospital in Hyderabad to get effective treatment for epilepsy and related health concerns.
