Surgical Help for Epileptic Patients
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Says Dr. Nusli Ichaporia of Jehangir Hospital and Medical Center, “Every year there are 15,000 people in Pune who develop epilepsy. Of these there are 10 to 20% who have medically intractable epilepsy”.
For these people, medication provides no relief. In these truly resistant type of epilepsy, despite proper choice of the standard drug, addition of new drugs and monitoring of blood levels, the seizures will continue without much change in their pattern of occurrence.
While the scenario may seem pretty bleak for such persons, surgery now provides hope. At the Epilepsy Center at Jehangir hospital, patients can undergo surgery for correction of their condition. In the Epilepsy Surgery program, 13 patients with resistant epilepsy underwent surgery.
The types of seizures that are surgically remediable are Mesial temporal sclerosis, tumors presenting with seizures as a pre dominant symptom, structural defects in the brain mostly from birth, and post brain injury gliosis.
Of the 13 patients, 5 had Mesial temporal sclerosis, and were between 25 to 35 years of age and had resistant epilepsy for 15 to 25 years. Clinically there was no focal neurological defect in most patients and neuro–psychology tests had to be done to show impaired function of the temporal lobe on the side of the sclerosis. Neuropsychological tests are necessary because MTS cannot be detected on CT or routine MRI.
4 patients had tumors, but these are without the usual symptoms of headaches, vomiting or focal neurological deficit typical of tumors. Yet another group of persons had brain injuries that resulted in seizures.
Says Ichchaporia, “With surgery, after a six month period, 85 percent of the patients had a good seizure control, and 90 percent showed an improvement in the quality of life”.
The surgery costs Rs. 30 to 45,000 a compared to $30,000 to 45,000 abroad but for the people suffering from epilepsy, this is more than just an issue about money.