Offering the most advanced epilepsy treatment & surgery in the Middle East at the Fakeeh University Hospital in Dubai. Treating both adult and pediatric patients.
Epilepsy is a common neurological disorder affecting 1 in 200 people. Our brain cells are constantly sending electrical signals and messages to each other. When a person has an epileptic seizure, it causes abnormal electrical activity in the brain. This interrupts the way the brain functions. This can cause normal processes to be interrupted and can make a person jerk, become stiff and even be unaware of the seizure they are experiencing.
Epilepsy can cause a range of symptoms and varies from person to person. Here are some of the possible symptoms you may be experiencing:
The primary symptom of epilepsy is a seizure, but there are many different types of seizures. It is best to speak to a specialist to find out more about them.
There is no clearly identifiable cause for most types of epilepsy. Sometimes it can be due to family genes, which you could have inherited. Other possible causes are associated with damage to the brain, like a brain tumour, stroke, head injury, substance abuse, or infection.
Seizures vary so much that specialists frequently classify seizures by type. Typically, seizures belong to one of two basic categories:
The difference between these types is in how they begin. Primary generalised seizures begin with a widespread electrical discharge that involves both sides of the brain at the same time. Partial seizures begin with an electrical discharge in one limited area of the brain.
Seizures that begin from both sides of the brain simultaneously are called primary generalised epilepsy. Hereditary factors are essential in partial generalised epilepsy, which is more likely to involve genetic factors than in partial epilepsy. This is a condition in which seizures arise from a limited area of the brain. Some partial seizures are related to head injury, brain infection, stroke, or tumour, but the cause is unknown in most cases.
Whether consciousness (the ability to respond and remember) is impaired or preserved is a determining factor or consideration. when attempting to classify partial seizures is whether the difference may seem obvious. Still, there are many degrees of consciousness impairment or preservation.
Factors that may increase the risk of seizures in people predisposed to seizures include:
About half of the people who have one seizure without a clear cause will have another one, usually within six months. A person is twice as likely to have another seizure if there is a known brain injury or another type of brain abnormality. If the patient has two seizures, there is about an 80% chance of having more. If the first seizure occurred at the time of an injury or infection in the brain, it is more likely that the patient will develop epilepsy than if the seizure did not happen at the time of injury or infection.
Epileptic seizures result from abnormal activity of specific brain cells (neurons). The type of surgery depends on the patient’s age and the location of the neurons that start the seizure, and the patient’s age. There are various advanced epilepsy treatment & surgery options for the management of epilepsy. In some cases, anti-epileptic medications help prevent or control seizures. Other advanced and popular forms of treatment can be Vagus nerve stimulation VNS and Deep brain stimulation DBS.
Surgical intervention can be considered for severe and life-affecting types and causes of epilepsy. Surgery for epilepsy is not taken lightly; several tests will be carried out before any surgical intervention, such as EEG, brain scans and memory/ability testing. All of this will feed us information about a patient’s epilepsy condition to provide the best possible outcome for the patient.
Epilepsy surgery is performed to either remove the brain area where seizures occur or stop the spread of seizure activity. It is a treatment option for people with seizures that cannot be controlled with medication. Epilepsy surgery is not the first line of treatment. Still, it will be considered when at least two anti-seizure drugs have failed to control seizures. This is a condition known as medically refractory epilepsy or drug-resistant epilepsy. Epilepsy surgery is most effective when seizures occur in a single location in the brain.
As mentioned, several pre-surgical tests are necessary to determine whether you’re eligible for epilepsy surgery. The goal of epilepsy surgery is to stop seizures or limit their severity with or without the use of medications.
Advanced epilepsy treatment & epilepsy surgery available include the following:
Deep brain stimulation (DBS): is when a device is permanently implanted deep inside the brain, The device release regularly timed electrical signals that disrupt abnormal, seizure-inducing activity. This is an MRI-guided procedure. The generator sending the electrical pulse is implanted in the chest.
Resective surgery: is typically the most common epilepsy surgery and involves the removal of a small portion of the brain. The surgeon cuts out brain tissues in the area of the brain where seizures occur, usually the site of a tumour, brain injury or malformation. Resection surgery is most often performed on one of the temporal lobes, an area that controls visual memory, language comprehension and emotions.
Laser interstitial thermal therapy (LITT): is a less invasive surgery that uses a laser to pinpoint and destroy a small portion of brain tissue. Magnetic resonance imaging (MRI) is used to guide the laser the surgeon uses.
Corpus callosotomy: is surgery to wholly or partially remove part of the brain that connects nerves on the right and left sides of the brain (corpus callosum). This is usually used with children who experience abnormal brain activity that spreads from one side of the brain to the other.
Hemispherectomy: is a procedure to remove one side (hemisphere) of the folded grey matter of the brain (cerebral cortex). This surgery is generally reserved for children who experience seizures originating from multiple sites in one hemisphere. This is usually due to a condition present at birth or in early infancy.
Functional hemispherectomy: is a procedure primarily used in children that removes the connection nerves without removing actual pieces of the brain.
Multiple subpial transections (MST): in certain cases of epilepsy, where the seizures are deemed to be arising from an area of the brain that cannot be safely removed, multiple subpial transections can be performed. In this procedure, a small wire is placed into the brain to perform transections at multiple points in a given region which can decrease seizures by disconnecting the cross-communication of neurons.
Stereotactic radiosurgery: involves the delivery of a focused beam of radiation to a specific target area. Gamma Knife radiosurgery, one of the most common forms of radiosurgery, uses gamma rays to target the area to be treated. In epilepsy, it is generally reserved for small, deep-seated lesions that are visible on MR imaging.
Vagus nerve stimulation (VNS): is the implantation pulse generator. Lead wire stimulates the vagus nerve, which stabilises abnormal electrical activity in the brain.
Responsive neurostimulation (RNS): The NeuroPace responsive neurostimulation (RNS) device was approved by the FDA in 2014 as a treatment for adults with partial-onset seizures with one or two seizure onset zones. It can be used where seizures have not been controlled with two or more antiepileptic drugs. Surgery involves placing a neurostimulator in the skull and connecting to two electrodes placed either on the surface or into the brain, in or around the area deemed to be the likely onset region for the seizure. The device records brain waves (EEG). It is trained by the epileptologist to detect the electrical signature of the seizure onset and then deliver an impulse that can stop the seizure. This surgery is generally reserved for patients who are not candidates for surgical resection. The RNS improves seizure control but rarely stops seizures from occurring.
This information is provided as a guide only, For all medical concerns or diagnosis, please consult a registered specialist. As with any surgical procedure, there are risks involved. A patient’s age, medical condition, and symptoms must be considered before any of the above-mentioned procedures can be considered to determine suitability for treatment.
Learn More about advanced epilepsy treatment & surgery options offered by Dr Tommaso Tufo. Book a face-to-face appointment at the Fakeeh University Hospital. Call+971-(0)-4-414 4444 or Book an Online Appointment Today to discuss your case.
You can visit the clinic of Professor Tommaso Tufo at the Fakeeh Hospital in Dubai or alternatively, you can book an online appointment today. In some situations, the hospital can arrange a home visit. Surgeries have resumed and we continue to offer virtual consultations for all patients. We are working to ensure a safe environment, taking all Covid-19 precautions so that you can be confident in getting the care you need.
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