stage
Brief explanation for the patient
Important point
decision for surgery
The doctor will determine if surgery is necessary by reviewing the results of the tests
Decision making is completely specialized and individual
Surgical procedure
Anesthesia, removing part of the skull, brain mapping, treating traumatic tissue, closing the skull
In some cases, part of the operation is performed with the patient awake to preserve vital functions
Post-operative care
ICU admission, pain control, monitoring of vital signs and brain function
It is necessary to continue taking anticonvulsants
Rehabilitation and return to normal life
Gradual increase of activities, physiotherapy and counseling if needed
Heavy activities should be done with the doctor's opinion
Medications after surgery
Most anticonvulsants are continued and the dose is gradually reduced according to the doctor's opinion
Sudden discontinuation of the drug risks the return of seizures
Surgery in children
It is done more carefully so that the growth and function of the brain is not affected
Special postoperative care is necessary for children
The steps of treating seizures with the help of brain surgery begin with a careful examination and review of the medical history. At this stage, the neurologist examines the general condition of the patient and evaluates the medical history of the patient and his family to determine the factors affecting seizures. In addition, the presence of a person who witnessed the attack can provide the doctor with important information about the details of the seizures and is very useful in making a more accurate diagnosis.
The main goal of these investigations and subsequent tests is to identify the starting point of seizures in the brain; That is, the area where abnormal electrical activity causes seizures, and its identification is of great importance to choose the best treatment method, including brain surgery or brain tumor surgery if there is a lesion.
Important diagnostic tests:
After carefully examining and analyzing the results of all tests and diagnostic tests, the specialist doctor decides whether surgery is necessary and appropriate to control the seizures.
To seizure treatment with brain surgery, there are various methods. These methods are specifically designed to control seizures, but if the seizure is caused by a lesion such as a brain tumor, you can also focus on brain tumor treatment at the same time. In the following, we will examine the three main methods and two more specialized approaches to seizure control.
In this method, the area of the brain that causes the seizure is carefully removed. For patients with a specific focus, this surgery has a high chance of reducing or stopping seizures.
With the help of laser waves, the brain tissue causing seizures is precisely and minimally invasively heated and destroyed. This method has a shorter recovery period than open surgery.
Electrodes are implanted in specific areas of the brain to control nerve activity and reduce the number of seizures. This method is used for patients who are not suitable for resective surgery.
In severe or complex cases where seizures are widespread, connectivity between the hemispheres is reduced or parts of the brain are separated to limit the spread of seizures.
The process of treating seizures with brain surgery begins with the preparation of the surgical area and anesthesia of the patient. The specialist doctor shaves a part of the patient's head and then puts the patient under complete anesthesia so that he does not feel any pain during the operation and is completely comfortable. During surgery, the intensive care team carefully monitors the patient's heart rate, blood pressure, and blood oxygen levels to ensure patient safety.
Key stages of brain surgery to treat seizures:
Surgery is one of the effective methods to treat seizures with brain surgery, especially in patients who have not responded to anticonvulsant drugs. The main benefits include:
According to Dr. Orrin Devinsky, an epileptologist at New York University: “For patients who do not respond to medications, surgery can completely change their lives and restore independence and quality of life.”
Any brain surgery carries risks, and patients should be aware of them. The most important risks include the following:
According to Epilepsy Foundation:"Careful patient selection and surgery performed by an expert and experienced team is the most important factor in reducing complications and increasing treatment success."
Care after brain surgery is very critical for seizure control and patient recovery. After surgery, the patient is usually admitted to the intensive care unit for a few days to be closely monitored. The medical team checks the patient's heart rate, blood pressure, breathing, level of consciousness and movement abilities and controls his pain with appropriate drugs. Adequate rest and accurate use of prescribed medications will help reduce post-operative symptoms such as headache, dizziness and fatigue.
Yes, pediatric brain surgery is significantly different because children's brains are still growing and developing. Doctors should be more careful in choosing surgical methods and areas to ensure that it has the least possible impact on the child's cognitive and neurological functions.
Also, after surgery, children may need extra care to ensure that no complications affect their normal development.
Yes, in many cases, patients still need to take anticonvulsants after brain surgery. These drugs help control seizures and reduce the risk of them recurring. Although surgery may greatly reduce or even stop seizures, doctors usually taper the medication gradually to prevent new seizures.
Brain surgery can initially affect daily activities. Depending on the type of surgery and the area of the brain treated, patients may experience limitations in movement, memory, or concentration.
In the first days or weeks after surgery, it is necessary to rest and avoid heavy activities. But with the passage of time and following rehabilitation and physiotherapy programs, most patients return to their normal activities.
Seizure treatment with brain surgery is an important and effective option for patients who continue to suffer from severe seizures despite the use of anticonvulsants. By focusing on identifying and treating the main source of this problem in the brain, this method can help significantly reduce or even completely stop seizures.
However, brain surgery is a big and complex decision that requires careful investigations, specialized tests and many consultations. After performing this operation, a period of special care and rehabilitation is necessary for the person to fully recover and return to normal life; Also, according to authoritative sources some patients may need to take anti-seizure medications to prevent recurrences.
If you have experience with seizure treatment, we would be happy to share your views in the comments section so that others can use your words and make better decisions.
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Dr. Yazdan Panahi
Student of Shahid Beheshti University of Tehran. The top rank of the specialized board of neurosurgery. 7-year history of performing complex operations on the base of the skull and brain and spinal cord tumors, 7-year history of complex operations on the spine
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