How Surgery Helps People with Brain Tumors and Epilepsy

Epilepsy Surgery:

Epilepsy neurosurgery is a specialized field that aims to treat epilepsy, a neurological disorder characterized by recurrent seizures. When epilepsy is caused by a brain tumor, surgical intervention becomes an essential option. The primary goal of surgery is to remove the tumor, alleviate seizure activity, and improve the patient's overall quality of life. This multidisciplinary approach involves highly skilled neurosurgeons, epileptologists, and other medical professionals working together to ensure the best possible outcomes for patients.

Surgical Procedures for Brain Tumors and Epilepsy:

Surgery for Epilepsy can be done either for lesions(tumors) or non-lesions (non-tumorous conditions).

The first strategy is resective surgery for lesions and it could be either resective or disconnective surgery in the latter.

Resective surgery involves the removal of the brain tissue where the tumor is located, while disconnective surgery involves severing the neural pathways responsible for propagating seizures. Resective surgery is the most common approach for brain tumors, and it is performed using various techniques such as -

Temporal Lobectomy: Removal of the temporal lobe, a common site for epilepsy and brain tumors located in temporal lobe.

Lesionectomy: Targeted removal of the tumor and surrounding abnormal tissue.

Epilepsy Neurosurgical Advancements:

Advancements in epilepsy surgery have revolutionized treatment options and improved patient outcomes. Some notable advancements include:

Minimally Invasive Techniques: Utilizing advanced imaging and surgical tools to perform less invasive procedures, called as keyhole techniques for reducing postoperative complications and recovery time.

Stereotactic Navigation: Precise mapping and navigation systems aid surgeons in locating and removing tumors with greater accuracy, minimizing damage to healthy brain tissue.

Laser Interstitial Thermal Therapy (LITT): This technique uses laser energy to ablate the tumor, making it a viable option for deep-seated or inoperable tumors.

Responsive Neurostimulation (RNS): Implanted devices detect abnormal brain activity and deliver targeted electrical stimulation to prevent seizures.

Intraoperative Monitoring: Real-time monitoring during surgery helps identify critical brain regions and preserve vital functions.

Risk Factors Associated with Epilepsy Surgery:

While epilepsy surgery can be highly effective, it is not without risks. Potential complications include infection, bleeding, neurological deficits, and cognitive changes. Careful patient selection, comprehensive preoperative evaluation, and meticulous surgical planning are crucial in minimizing these risks.

Benefits of Surgery for Brain Tumor and Epilepsy:

Epilepsy surgery offers several significant benefits for patients with brain tumors and associated seizures. By removing the tumor and controlling seizure activity, patients can experience:

Improved Seizure Control: Many patients become seizure-free or experience a significant reduction in seizure frequency.

Enhanced Quality of Life: Seizure freedom allows individuals to resume daily activities, drive, and engage in social interactions.

Decreased Medication Dependency: Successful surgery may lead to a reduced need for antiepileptic medications and their associated side effects.

Positive Outcomes of Epilepsy Surgery:

Several positive outcomes can result from successful epilepsy neurosurgery:

Seizure Freedom: A considerable number of patients achieve complete seizure remission, offering them a new lease on life.

Cognitive Improvement: Properly selected patients may experience enhanced cognitive function and memory after surgery.

Emotional Well-being: Seizure control can lead to reduced anxiety, depression, and other emotional difficulties.

Dr. Hrishikesh Sarkar
Senior Consultant – Neurosurgery,
Apollo Cancer Centre, Chennai