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Epilepsy management by functional neurosurgery

Date :17-Mar-2020

Epilepsy is considered to be a neurological disorder wherein the brain activity turns to be abnormal. This abnormality would cause seizures or periods of unusual behavior, sensations, and loss of awareness. Epilepsy is caused by certain factors such as head trauma, infectious diseases, prenatal injury, developmental disorders, and genetics. Epilepsy can be managed with medications; however, surgery would be recommended when medication fails.


The doctor would check the symptoms and medical history of the patient before the treatment. A neurological examination and blood tests would be performed to determine the type of epilepsy, identify infections, genetic disorders associated with seizures. With the help of stereotactic EEG (electroencephalogram), the doctor would insert electrodes into the brain to identify epileptogenic zones (where seizures begin). The position of the electrodes will be reconstructed using CT or MRI scans. This provides a three-dimensional understanding of seizure.

Lobectomy - helps to remove the entire lobe of the brain. Temporal lobectomy and frontal lobectomy would be used to treat epilepsy. An incision will be made, and a craniotomy would be performed. With the help of EEG, the surgeon will identify the exact location of the seizure and will remove it.

Corpus callosotomy - this would help interrupt the spread of seizures from hemisphere to hemisphere. This would require exposing the brain using craniotomy. A small incision will be made in the scalp to remove a piece of bone and pull back a section of the dura (the tough membrane that covers the brain). This would help the surgeon to insert special instruments for disconnecting corpus callosum.

Vagus nerve stimulation - the stimulator will be connected to the vagus nerve in the neck, and this could reduce seizures by 20-40 percent.

Responsive Neurostimulation (RNS) - these implants are like pacemakers, which would help prevent seizures. These stimulators would analyze the brain activity patterns to detect seizures before it occurs and would deliver an electrical charge or drug to stop the seizure.

Stereotactic laser ablation - direct radiation would be given at the specific area in the brain where seizures are caused. And this would help to destroy the tissue and put a better control of the seizures.

Lesionectomy – It is an operation to remove a lesion or an abnormally functioning area in the brain. This procedure would require exposing the brain using craniotomy. The doctor would make a tiny incision to remove a piece of bone and pull back a section of the dura. And this would help the doctor to insert special instruments for removing the brain tissue.

Hemispherectomy - a surgical procedure that helps in either partial or total removal of the affected cerebral hemisphere or disconnects the affected cerebral hemisphere from the unaffected area.

Corticectomy – It is a surgical procedure that helps to remove a specific portion of the cerebral cortex. This would be performed in conjunction with another surgical procedure for seizure control in epilepsy.

Reviewed By: Dr Shyam Sundar K
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Dr. Shyam Sundar K

Dr. Shyam Sundar K is an eminent name in the field of neurology. He is one of the best neurosurgeon in Chennai, Tamil Nadu

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