Epilepsy surgery is a treatment option for epilepsy, also known as epilepsy. Epilepsy is a chronic disease characterized by seizures caused by abnormal electrical activity of nerve cells. While the vast majority of epilepsy patients can be treated with medication, approximately 10% of patients who do not respond to medication or cannot be controlled may need surgical treatments. These surgical interventions aim to achieve seizure control by identifying and neutralizing the source of abnormal electrical activity in the brain.
Epilepsy surgery is determined as a result of a multidisciplinary evaluation process for suitable candidates and is managed by neurosurgery and neurology specialists.
How is eligibility for epilepsy surgery determined?
It is important to note that not every epilepsy patient needs surgery. In general, patients who experience persistent epilepsy attacks for more than 1 year, despite treatment with at least two different high-dose medications, may be suitable candidates for surgery.
In order to decide on surgery, patients must first be evaluated in detail by a neurologist. These evaluations should include MRI and EEG examinations in an experienced and technologically advanced center. It is even more important in this process to make a correct decision before correctly determining the treatment.
If eligibility is determined after these evaluations, the neurosurgery team and the neurology team form a council and make a decision about the patient's condition. After this decision, the patient and his/her relatives are informed in detail. Identifying epilepsy surgery candidates requires a multidisciplinary approach and it is critical that patients are evaluated by a specialized team.
What are the Methods Used in Epilepsy Surgery?
There are several effective methods preferred in epilepsy surgery:
Microscopic Surgery: It involves surgical removal of the focal area in the brain that triggers epileptic seizures or regulation of electrical conduction. This procedure, which can be performed under neuronavigation and tomography guidance when necessary, has high success rates when performed with the right indications.
VNS (Vagal Nerve Stimulation): It involves placing a battery under the skin that stimulates the vagus nerve passing through the neck without touching the brain. It is a lower risk option compared to microscopic surgery and favorable results can be achieved in suitable patients.
DBS (Deep Brain Stimulation): This method, which is also used in Parkinson's disease, involves the placement of stimulating cables in certain parts of the brain under operating room conditions. These cables are connected to a battery placed under the skin and regulate the electrical activity of the brain. This method has a low risk of complications.
Each method is chosen depending on the patient's condition and needs. To decide which method to apply, a committee formed by neurosurgery and neurology doctors evaluates the patient's condition in detail and determines the most appropriate treatment option.
After Epilepsy Surgery
The process after epilepsy surgery varies depending on the patient's general health condition and the surgical method and technology used. After the operation, the patient may be observed in the intensive care unit and transferred to a regular care unit after stabilization.
In the first few weeks, regular health follow-ups are performed, medications are administered regularly and doses are adjusted. Rehabilitation programs can be implemented to support the recovery of motor skills and cognitive function. Post-operative check-ups are performed regularly and tests such as brain imaging and EEG are used to monitor brain activity.
Recommendations for lifestyle changes include regular sleep, healthy eating, stress avoidance and regular exercise. As each patient is different, the healthcare team manages the post-operative process according to individual needs and collaborates to ensure the patient's best recovery.