Epilepsy is a condition in the brain in which a short circuit occurs in the electrical conduction in the brain tissue. There are different forms of epilepsy. Usually, a seizure is thought to involve someone falling to the ground and convulsing. In some cases someone can be treated by surgery. In that case, there must be a clear focus where the attacks originate. Who is eligible for surgery and what does it entail?
What epilepsy means
Someone who suffers from epilepsy suffers from a disturbance in electrical conduction in the brain. A typical image is that someone falls and starts to jerk. There are also other forms of epilepsy. In some cases the outside world hardly notices it. Someone may be absent for a while. Epilepsy can occur in one part of the brain, but it can also occur anywhere in the brain. In many cases, attacks can be treated with medications. There are people who are therefore free from attacks or have attacks much less often.
An operation
Sometimes epilepsy can be treated with surgery. Not everyone qualifies. There must be a clear focus in the brain where the epileptic seizure originates. This is then surgically removed or shut down. It is a major operation that involves risks. Every year, about a hundred people in the Netherlands undergo surgery for epilepsy. After the operation it will quickly become clear what the result is.
Who is eligible?
Surgery can only be performed in certain cases, for example when someone cannot control their seizures with medication. If someone suffers a lot from the attacks, a decision can be made to operate in consultation with the doctor. Furthermore, a person must have one to two foci from which the attacks originate. If the attacks arise from more than two foci, surgery is not possible. The epilepsy usually occurs in the entire brain area. A neurologist determines whether you are eligible for surgery. He may refer you to an epilepsy center or to an academic center.
The result
Sometimes the fireplace is (partially) removed. It is also possible that the fireplace remains in place, but is switched off. Most importantly, surgery should not lead to loss of important functions such as loss of speech, permanent paralysis, blindness or severe memory loss. If there is a chance of this happening, the operation will not go ahead. In general, surgery will reduce or make the attacks less severe. Sometimes they disappear completely.
The phases of the operation
If preliminary research shows that you are a candidate for surgery, the process will be started. This is divided into a number of phases:
Phase 1
In the first phase, non-invasive research is done. These are examinations that do not involve interventions, but examinations such as an EEG, neuropsychological examination and MRI scan. This period can take quite some time.
Phase 2
In this phase, invasive research is done, such as a WADA test (brain examination via carotid artery injection) or a depth EEG (applying electrodes under the skull). There are some risks associated with this.
Phase 3
In this phase the operation is performed.
Phase 4
After the operation, the patient is re-examined. It is checked whether everything went well and whether the operation had an effect. You will remain under the supervision of your treating physician for a while.
Just after the operation
Brain tissue may swell as a result of the operation. This can lead to all kinds of problems, such as temporary (a few days) loss of strength in one half of the body or speech problems. The moment the swelling decreases, the complaints will disappear. There is a one percent chance of serious brain damage after surgery.
Successful operation
There is a chance that a few more attacks will follow, but there is a good chance that you will be attack-free. If you still have attacks after two weeks, the operation was not (completely) successful. When you are seizure-free or suffer fewer attacks, life can suddenly look very different. You may be able to drive, pursue hobbies or work again.
read more
- Epilepsy: the consequences and the influence on your life
- Epilepsy due to brain damage: symptoms and causes
- Epilepsy: what does a seizure mean and what are the symptoms?
- Epilepsy: two different main types
- Treating epilepsy with medications
