Epilepsy Surgery in Indore

 Epilepsy can impact every aspect of a person’s life – school, work, travel, relationships and even simple daily activities. Most people with seizures are well controlled with regular medicines and they lead full and active life. But for a big chunk of patients, even the right medications in the right doses don’t stop seizures. For them, surgery can offer a real chance to get it under better control.

Epilepsy surgery is a specialized treatment for patients who cannot be adequately controlled with medication only. The goal of surgery is to find and treat the area of the brain that is starting the seizures, to help reduce or stop them completely. For the right patients, epilepsy surgery in Indore has been shown to offer a way to dramatically improve quality of life, independence and long-term neurological health.

This page will guide you through understanding epilepsy, its symptoms, when surgery might be an option, how patients are assessed, the available procedures, the recovery process, and how to choose the right epilepsy surgeon in Indore.

What is Epilepsy?

Epilepsy is a disorder of the nervous system in which the person has repeated seizures from abrupt, abnormal electrical activity in the brain. Not everyone who has a seizure has epilepsy. Usually, the diagnosis is made after a person has had two or more unprovoked seizures or when testing shows a high probability of more seizures.

Seizures can start in one part of the brain (focal seizures) or can involve both parts of the brain from the beginning (generalized seizures). Epilepsy can affect people of any age and can be caused by many different factors including injury at birth, trauma, infections such as meningitis or neurocysticercosis, stroke, brain tumors, scarring in the brain, abnormal development of the brain and genetic factors. Many patients do not have a single cause.
Epilepsy is not contagious, it is not caused by evil spirits and it is not a sign of weak character. It is a medical condition which can be diagnosed and treated and in modern time, the treatment for seizures varies from medicines to surgery and people with epilepsy deserve understanding and support rather than fear or stigma.

Signs and Symptoms of Seizures and Epilepsy

Depending on the type of seizure and the part of the brain involved, epilepsy may cause a variety of symptoms. Signs of:

• Repeated seizures, which can include convulsions with shaking of the whole body
• A temporary state of confusion or daze
• Losing consciousness, the person appears to be there but does not respond
• Jerking of one part of the body or uncontrolled movements of the arms or legs
• Staring spells that may last a few seconds and may be confused with daydreaming
• Unusual sensations such as a rising feeling in the stomach, weird smell or taste, sudden fear or feeling that an event has happened before
• Repetitive movements such as lip smacking, chewing or fiddling with the hands
• Loss of consciousness, sometimes followed by drowsiness, headache or confusion
• Unprovoked, unexpected falls in some types of epilepsy

If you still experience seizures after taking the prescribed medicines, then you must consult an epilepsy specialist in Indore for further evaluation. Seizures are disruptive and ongoing seizures can lead to injury, accidents, memory and learning problems, emotional strain, and occasionally serious complications.

What is Drug-Resistant Epilepsy?

Drug-resistant epilepsy is the failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drugs (AEDs) (whether as monotherapies or in combination) to achieve sustained seizure freedom. This happens in about one third of people with epilepsy. Every drug that doesn’t work reduces the chances that other medicines will.

Before declaring epilepsy drug resistant, doctors need to be sure of the diagnosis, as some conditions such as fainting spells or psychogenic non-epileptic events may mimic epilepsy. They also confirm that medicines were taken regularly, the doses were adequate and triggers such as lack of sleep were not responsible. Once drug resistance is established, referral to an epilepsy surgery program is recommended without undue delay, as early surgery can prevent years of preventable seizures.

Timely drug resistant epilepsy treatment offers patients the opportunity to find out whether surgery could help them, rather than continuing to struggle with seizures and side effects of medicine.

Who is a Candidate for Epilepsy Surgery?

Not everyone with epilepsy is a surgical candidate, and not everyone with epilepsy needs surgery. Indications for surgery include:

• Seizures continue with two or more appropriate drugs
• Seizures come from a specific part of the brain that can be safely treated
• Seizures have a major impact on safety, quality of life, education or employment
• Causing a visual defect (tumor, scar, abnormal vessel or developmental abnormality)
• Seizures are interfering with development or learning in children
• The patient and family understand the benefits and risks and wish to proceed

Surgery may not be appropriate if the source of the seizures is in an area that controls vital functions and cannot be removed safely, or if serious medical conditions make surgery unsafe. Surgery may also be less appropriate if seizures come from multiple areas of the brain at the same time. Even then, there are other options such as devices or diet and medicine adjustments.

Types of Epilepsy Surgery

Depending on the site and etiology of the seizures, different types of epilepsy surgery can be done. These may involve surgery to remove the area causing seizures, surgery to disconnect abnormal nerve pathways, or surgery to implant devices to help control seizure activity. Each patient is thoroughly evaluated and the most appropriate treatment is determined.

Resective surgery (removal of the seizure focus)
This is the most common and often the most effective kind of seizure surgery in Indore and elsewhere. The surgeon removes the small area of the brain where the seizures start. 

• Temporal lobe surgery: The most common procedure is removal of part of the temporal lobe, including the hippocampus. It is often done for mesial temporal sclerosis, a scar-like change in the hippocampus, and gives many patients a good chance to be seizure-free.
• Lesionectomy: Excision of a discrete lesion, such as a tumor, cavernous malformation, or area of abnormal brain development (focal cortical dysplasia), and the surrounding seizure-generating area
• Extratemporal resections: Resection of seizure producing areas in the frontal, parietal or occipital lobes with careful attention to preservation of critical functions.

Disconnection Procedures

These procedures cut abnormal pathways to prevent the spread of seizures rather than removing tissue.

• Corpus callosotomy: The bridge of fibers connecting the two sides of the brain is cut. It is mainly used for the severe type of drop attacks, where the patients fall suddenly and hurt themselves
• Hemispherotomy: In children who have severe damage or abnormal development confined to one side of the brain, that side is disconnected from the rest of the brain. In carefully selected patients this can lead to dramatic improvement in seizures.
• Multiple subpial transection: multiple fine cuts are made in the surface of the brain in areas that cannot be removed, such as areas controlling speech or movement

Minimally Invasive Procedures

For some patients, a small opening may be made to heat and destroy a small seizure focus with a thin laser probe (laser interstitial thermal therapy). Another option for some deep seizure sources is radiosurgery. These options are not always available or appropriate in all settings and your surgeon will discuss the suitability of these options.

Neuromodulation Devices

If the cause of the seizures cannot be removed, devices may help decrease the frequency of seizures.

• Vagus nerve stimulation (VNS) – a small device is implanted under the skin of the chest and delivers mild electrical pulses to the brain through the vagus nerve in the neck
• Responsive neurostimulation (RNS) and deep brain stimulation (DBS): Implanted devices that sense or block abnormal electrical activity in selected patients
  These devices tend not to cure seizures but rather to reduce them, and can make a meaningful difference in quality of life.

How is a Patient Evaluated for Epilepsy Surgery?

The approach to treatment begins with a thorough neurological evaluation that may include advanced imaging, EEG monitoring and other tests to identify the source of seizures. This phase is the most important part of the journey. This is because the aim of surgery is to treat the exact focus of seizure. The evaluation usually includes:

1. History and examination: The doctor will ask for a description of the seizure, how often they happen, any past medications, and if there were any witnesses in the family. Often a video of the seizure recorded by family is very helpful.
2. Brain MRI (Epilepsy Protocol): Certain thin slice MRI sequences can detect scar tissue, abnormal development, tumors, or other lesions that may be causing seizures.
3. EEG and video-EEG monitoring: The patient is monitored while brain activity and video are recorded to help capture seizures and link them to electrical activity in the brain. This is the big test to find out where the seizures are coming from.
4. PET and SPECT scans: These scans show areas of abnormal activity in the brain and can help to find the source of seizures when the MRI is not clear.
5. Neuropsychological testing: Tests of memory, language, attention and mood can help predict how thinking might be affected by surgery and help plan the safest surgery.
6. Mapping techniques: fMRI and others They are used to find the areas of the brain that control speech, movement and memory, so they can be avoided during surgery.
7. Invasive monitoring in selected cases: In cases where the seizure focus is not well defined, thin electrodes may be temporarily placed on or inside the brain to record seizures directly. This allows for precise planning before any removal.

Once all the tests are finished, the results are examined together, ideally by a team of neurologists, neurosurgeons, radiologists and neuropsychologists, to decide whether surgery is appropriate and the best type of surgery.

Treatment and Process: What to Expect

Once the seizure focus has been correctly localized, an individualized surgical plan is developed. The goal of the procedure is to eliminate or decrease seizures while protecting important brain functions such as speech, memory and movement. Postoperative follow-up and continued assessment assist patients in the recovery process and attaining long term seizure control.

Step 1: Planning and consultation

You will see the neurosurgeon to discuss your history, medications, test results and goals. We explain to you in simple terms what the expected benefits are, the chance of becoming seizure free and the potential risks, so that you and your family can make an informed decision.

Step 2 Preoperative Preparation

You will need regular blood tests, checks on your heart and lungs and an assessment for anesthesia. Do not stop taking seizure medication before surgery unless specifically told to do so. Your team will discuss fasting and other preparations with you.

Step 3 The operation

Operation is done under general anesthesia. Sometimes the areas of speech or movement are close to the target, so the patient may be awake part of the time during the procedure in order for the surgeon to check these functions in real time. Image-guided navigation and an operating microscope assist the surgeon in precision. The abnormal area is removed or disconnected and the wound is closed.

Step 4: Post-Surgery Monitoring

You are closely monitored for a short period in the intensive care or high dependency unit. Her neurological status, speech, movement and early seizures are checked regularly. Continued with medicines as per advice.

Step 5: Recovery and follow-up (long term)

When you are stable, you are in a regular room and are more active. Follow-up visits, scans and EEG’s track how you are doing. Seizure medicines are continued for a while after the surgery and are tapered only by the doctor, when seizure control is stable.

Benefits of Epilepsy Surgery

If the patient is a good candidate for surgery, possible benefits include:

• Seizure freedom for many well-chosen patients, especially those with temporal lobe epilepsy
• Reduced or less severe seizures even if not totally controlled
• Fewer medicines needed, less side effects in many cases
• Better working, less falls, injuries & accidents
• Improved quality of life, including better school or work performance, independence, and confidence
• Better development in children with early seizure control
• Lower long-term risks of uncontrolled seizures.
  The results are different from person to person and no surgeon can guaranty the seizures will stop. Your doctor will tell you what is possible for your type of epilepsy.

Recovery from Epilepsy Surgery

The type of surgery and your own health will determine your recovery. Generally:

• Hospital stay: Usually a few days, depending on the procedure and recovery time
• Activity: Walks early light are encouraged. For several weeks, avoid strenuous activity and heavy lifting.
• Medication: Patients are continued on their seizure medicines after surgery and are never abruptly stopped. Reduction is gradual, usually after a long period of being seizure-free, and done under medical supervision
• Wound care: Follow directions to keep wound clean and dry
• Early seizures: Seizures that occur in the first few days or weeks do not necessarily mean surgery has failed but should be reported to doctor
• Driving and safety: You can only return to driving if your seizures are under control and the rules are followed. Follow your doctors advise.
• Emotional recovery: It takes time to adjust to a new life with fewer seizures. Counseling and family support can assist
• Return to school or work: Many patients are able to return to their normal activities within a few weeks to a few months as directed by the surgeon

Regular visits, scans and EEGs as needed. Long term follow up. Part of care.

Seizure First Aid: What Family Members Should Know

Knowing what to do if someone is having a seizure can prevent injury. If someone has a convulsive seizure:

• Remain calm and record the time of the seizure
• Move hard or sharp objects away and put something soft under the head
• When the shaking stops, turn the person gently onto his or her side.
• Loosen tight clothing around the neck.
• Stay with the person until they are fully awake

Do not put anything in the person’s mouth, do not hold them down and do not give food, water or medicine until they are fully alert. Call for emergency medical assistance or take the person to the nearest hospital if the seizure lasts more than five minutes, if the seizures occur one after another without recovery in between, if the person is injured, if the person has difficulty breathing or if this is the first seizure.

Why Choose Us for Epilepsy Surgery in Indore

One of the biggest decisions you’ll make on this journey is which team you choose. Dr. Siddharth Sharma is trusted Neurosurgeon in Indore offers advanced evaluation and surgical treatment of epilepsy with modern neurosurgical techniques and evidence based care. We provide each patient with a tailored treatment plan emphasizing safety, accuracy and best possible results.

Dr Siddharth Sharma is an epilepsy surgeon in Indore, who offers care that starts with understanding your seizures and ends only when you are settled into long term follow up. Patients and families should expect:

• Careful patient selection: surgery is only recommended if tests show that it can really help
• Tailored plans: Your treatment plan is based on your particular seizure type, test results, health and goals
• Protect function as much as possible: Protect speech, memory, vision and movement
• Clear discourse: Benefits, risks and alternatives are communicated clearly, without unrealistic promises
• Comprehensive support: Guidance from the evaluation to rehabilitation and follow-up

If you are looking for the neurosurgeon in Indore or a second opinion whether surgery can help you or your child, an open discussion is the best way to start.

How to Choose the Right Epilepsy Doctor and Surgeon

If you are looking for an epilepsy doctor in Indore keep these things in notice:

1. Team approach: The results in epilepsy surgery are achieved when neurologists, neurosurgeons, radiologists and neuropsychologists review the case as a team
2. Experience: Look for a neurosurgeon who has experience with brain surgery and epilepsy procedures
3. Evaluation facilities: Video-EEG, advanced MRI and other testing is necessary for correct selection
4. Honest advice: If surgery is not suitable, a good specialist will tell you straight away and offer you other options
5. Continuing care: Treatment involves long-term care and medication review

Do not hesitate to get a second opinion. You have this right.

When Should You See a Specialist?

See an epilepsy specialist or a neurosurgeon urgently if:

• Seizures that do not respond to two or more medications
• Medicines have problematic side-effects
• Seizures are causing you injury or limiting your daily life
• Seizures affect a child’s development or learning
• Seizures and a lesion (such as a tumor or scar) seen on an MRI
• You’d like a second opinion on your treatment plan for epilepsy

If the seizure lasts more than five minutes, or if it recurs without the person regaining consciousness, or if it occurs after a head injury, go immediately to the nearest emergency department.

Begin Your Journey to Better Seizure Control

You don’t have to live with seizures on and on. Many patients with drug resistant epilepsy, with a thorough evaluation and a well-planned treatment, can look forward to fewer seizures, greater independence and a better quality of life.

Early consultation can help determine the reliable treatment approach if you or a loved one have ongoing seizures despite medication. Book an appointment with Dr. Siddharth Sharma on Is Epilepsy Surgery for You. Call today at +91-9238869854 to book your appointment for expert neurosurgical care.