There are many famous people in history with epilepsy, such as Hippocrates, who was not prevented by Dr. Faisal Al-Ruwais * has epilepsy from practicing his life effectively and there is a lot of jealousy. This is why most people with epilepsy live well with the disease. But there is a group of patients who do not respond to the disease to drug treatment, so the medical team resorting to epilepsy surgery to remove the epileptic focus.
Surgical attempts to treat intractable epilepsy began in the late 2000s, when damaged brain tissue was removed from a head injury. It was found that this surgical procedure effectively controls epilepsy. There are patients who have been cured of epilepsy. In the last century, studies and research in the surgical treatment of epilepsy have continued, and it has been found that about 30% or more of epilepsy patients help in surgery to recover completely or reduce the severity and number of epileptic seizures.
Epilepsy surgery is summarized in the following surgical procedures
1- Installation of internal EEG slides: in the event that the location of the epilepsy is not determined by external planning.
Thin slices are placed on the surface of the brain to identify the epileptic focus. The patient is then monitored in the epilepsy treatment unit.
2- Removal of the epileptiform focus: This type of surgical intervention is considered the most effective, especially if the epileptiform focus is located in the temporal lobe in the event of atrophy and fibrosis in this region.
Hippocampal sclerosis
3- Separation of certain parts of the brain: This process is done to significantly reduce the severity of epilepsy, as the epileptic region is isolated from the rest of the parts of the brain or the two lobes of the brain are separated from each other, and there is a kind of subtle separation of the cerebral cortex in the event that the epileptic focus is located in a place that contains brain functions As sensitive as movement centers, this process is called cortical striping.
4- Electrical stimulation of the brain: There are many patients who suffer from general and unspecified epilepsy in a specific place, and in these cases electrical stimulation of the brain is used to alleviate the severity of epilepsy, and there are two types of electrical stimulation available in centers in Saudi Arabia and in many international centers. The first type is vagus nerve stimulation in the neck where wires are implanted around the nerve in the neck attached to a battery in the upper chest in the left side and it is called Vagus Nerve Stimulation (VNS)
This device helps part of the patients in relieving epileptic seizures and the effectiveness of the device increases with the passage of time and increases the electrical stimulation while programming the device.
The second type is the installation of electrodes in specific nuclei inside the brain and linked to a battery that sends electrical charges to the brain to inhibit epilepsy, as recent medical studies have proven the effectiveness of this type of treatment.
New in epilepsy research
There are many researches conducted in various centers in the world, and these studies are making clear progress and encouraging results.
We mention, among them, the focused radiation therapy for the location of epilepsy, which inhibits the action of epileptic focus cells and destroys them without surgical intervention. The results are considered good for a few types of epilepsy, and this type of treatment needs more studies to determine the effectiveness of the treatment and its safe application.
Transplantation of epilepsy-inhibiting cells into the epileptic focus, which is the process of placing cells that have the ability to inhibit the action of cells that cause epileptic seizures
The process of cooling the epileptic focus by implanting a special device in the body linked to a small cooling device inside the epileptic focus.
Gene therapy, which is still in the laboratory research phase.
This is a brief overview of epilepsy surgery, and it is worth mentioning that the surgical treatment of epilepsy in the blessed month of Ramadan is carried out for patients who suffer from severe and recurring intractable epilepsy and other than this, it is a regular operation that can be performed at a later time according to the patient''s desire.
