"The decision of the suitability of operating on a patient to control epilepsy should be made within a multidisciplinary team, weighing well the risks-benefits of the intervention".
DR. ANA ARANSAY GARCÍA SPECIALIST. NEUROSURGERY DEPARTMENT
What is epilepsy surgery?
Epilepsy surgery requires a multidisciplinary team. The selection of the surgical candidate as well as the pre-surgical assessment with video-EEG monitoring, functional MRI and even invasive monitoring are key aspects to predict the success of surgery, since they identify the epileptogenic lesion area.
The most frequently used surgery is the hypocampectomy (removal of the temporal pole below the first temporal gyrus) and subpial exeresis of the hippocampus, entorhinal cortex and amygdala. All this can be about 3 cm long.
The results of the surgery are validated by scales and by the reduction of antiepileptic medication.
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When is surgery for epilepsy indicated?
Among the types of epilepsy, the most common is that of the temporal lobe and is the only type of curable disease.
Drug treatment manages to control 80% of patients with temporal lobe seizures, but the rest do not respond to various antiepileptic treatments in which drugs are prescribed.
The rest of the patients (20%) who do not respond to drugs are candidates for intervention. Of these, 75% may improve with surgery.
Do you have any of these diseases?
You may need to have epilepsy surgery
How is epilepsy surgery performed?
It consists of removing a part of the brain tissue, with or without a visible lesion, related to the origin of the epileptic seizures. They are the focal seizures. Most of the time respond very well to surgical treatment.
It cuts only the nerve pathways that connect the areas where epileptic discharges occur with the rest of the brain. Prevents generalization by isolating the epileptic area.
It is a less successful and more risky option. For this reason, it is used in patients with crises that greatly compromise their quality of life, which do not respond to other treatment and in which the exeresis of the focus can not be made.
The main purpose of surgery is to cure epilepsy or, if not possible, to convert a resistant or intractable epilepsy into a sensitive or treatable epilepsy. Drug suppression is secondary.
These surgeries require a highly specialized hospital center, since it is necessary the interdepartmental collaboration of neurologists, neurophysiologists, neurosurgeons, etc.
The technical advances in surgery have allowed the patient to be operated on, sometimes under local anesthesia, and to have a much shorter post-surgical hospital stay.
After the operation, the patient will be admitted to the hospital for approximately 5-7 days to observe and confirm that everything is going well.
Neurophysiological controls and a magnetic resonance will be performed. After this time, the sutures will be removed and the patient will be discharged from the hospital.
Afterwards, the patient must follow a control at the Department of Neurology and Neurosurgery. The medication he was taking previously is not usually suspended, at least until a year has passed.
Where do we do it?
IN NAVARRA AND MADRID
The Department of Neurosurgery
at the Clínica Universidad de Navarra
The Neurosurgery Department has specialists with a great deal of experience in care and research and the most advanced technology.
We are the only Spanish center that incorporates high field intraoperative magnetic resonance (3T). This allows the maximum precision and control in cranial surgery.
We are the Spanish medical center with the most experience in Parkinson's surgery by means of deep brain stimulation. We have the latest technology with localized ultrasound (HIFU) and extensive experience in treating essential tremor and Parkinson's disease without an incision.
Why in Navarre?
- The only Spanish center with a high field intraoperative magnetic resonance (3T).
- Precision and minimally invasive surgery.
- Experts in the use of HIFU for the treatment of tremor.