Surgery offers hope to patients of drug-refractory epilepsy

Epilepsy, which affects 1% of children worldwide, begins at an early age. 25-30 percent of children with epilepsy continue to have seizures despite using two or more epilepsy medications. Today, epilepsy surgery is considered as an option that improves the quality of life for children with persistent epilepsy.

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Epilepsy can occur at any age, starting from the newborn. In the treatment of the disease, the first recommendation of physicians is drugs.   


In this case, the option of surgical operation comes to the fore with the joint evaluation of physicians from more than one branch. However, the surgical option should not be viewed as the only solution.   


Because despite the surgical application, there may be patients who have seizures, although not very often. Here, it is important to determine the patients who will undergo surgery very well.

First choice drug in the treatment of epilepsy

Although the treatment of epilepsy is mainly drug therapy, some patients do not get results despite drug therapy.   


It is thought that these patients have a focus that is absent in other patients. If this focus is detected and surgically removed, results can be as successful as drug treatment.   


It is not possible to give the same success rate for all epilepsy patients who underwent surgical operation. However, if it is considered that patients have constant seizures despite using two or three drugs, the success of surgery by more than 50 percent reduces the number of seizures and improves the quality of life of the patients.


In order for these operations to be performed on a patient with epilepsy, he must have received drug therapy for at least two years before the operation, and yet his seizures continued.   


About 70 percent of people with epilepsy can control their seizures with medication. 30 percent of patients continue to have seizures despite medical treatment. However, additional testing is required to determine whether a patient is a candidate for surgery. Thanks to this surgery, the part of the brain that causes seizures is removed.


The surgery is more successful in those who have seizures in a certain part of the brain

Epilepsy surgery has many different application methods. For this reason, when deciding which surgery will be applied to which patient, the type of seizures and where they start in the brain are looked at.  


Epilepsy surgery works best for people who have seizures in a particular area of ​​the brain. Before the surgery, the area in the brain where the seizures started is determined.   


For this purpose, besides imaging methods, many tests are performed. It is also necessary to make sure that the area where the seizures begin is not involved in important brain functions including speech, movement or memory.   


With the help of epilepsy surgery, it is possible to successfully and safely stop seizures in most cases by removing the seizure focus in the brain. Some patients may need a secondary surgery. However, many patients are permanently free of seizures or have significantly reduced seizures after surgery. This increases the quality of life.


As with any surgical treatment, epilepsy surgery has its own risks. One of the most feared risks is the continuation of seizures despite surgery. There are also risks associated with surgery and anesthesia. Apart from the absence of seizures, the most feared point is the risk of permanent damage to the brain.   


For this reason, when making decisions in epilepsy surgeries, patients should be handled with a multidisciplinary approach by physicians working in different branches by specialist physicians.