Epilepsy

EEG is the record of electrical activity in the brain using small, metal discs called electrodes. Electrodes are attached to the scalp with wires to track and record brain wave patterns. The results will be interpreted as a series of line on the recorded paper or shown on a computer screen. EEG can be carried out when the patient asleep, awake, or during epileptic seizure. The patient may also be asked to look at some flashing lights, to check for any brainwave patterns change. EEG is the common test to help the doctor diagnose epilepsy and determine what type of seizures so that the doctor can plan the suitable treatment and select the right anti-epileptic drugs.

 

75 percent of patients with epilepsy can be controlled with anti-epileptic drug.  However, 5-10 percent of the patients have the condition called medically intractable which means cannot be controlled by medications and surgery will become a treatment option for patients who do not respond to the anti-epileptic drug.  Below are the criteria or the test to assess whether the patient require the surgery.

 

1. Patients do not successfully respond to antiepileptic drug (AED)

2. 24-hour video EEG monitoring 

3. MRI Epilepsy Protocol

4. Neuropsychological testing

5. In some cases, functional imaging like PET Scan, SPECT will be done

6. Neurologist and Neurosurgeon together discuss the possibility of the surgery

 

If medicine does not work for some patients, operation to cure the seizure is possible. Surgery is performed to remove the area where seizure originates, which will not disrupt a critical function of the body. This type of the surgery can be performed on epilepsy that is caused by hippocampal sclerosis, tumor, cavernoma, AVM, cortical dysplasia, and Rasmussen’s encephalitis

 

On the other hand, if the seizure arises from many areas of the brain affecting the important function that these region control. The purpose of the surgery is then aimed to reduce the frequency of seizures and reduce severity from the injuries such as corpus callosotomy and vagus nerve stimulation