20% epileptic patients can be cured by brain surgery: Doctor

Abhishekh, 32, (name changed) was a serious patient of epileptic seizures and underwent brain surgery three years back and today he is free from drugs as well as seizure.

The anterior of the temporal region of the brain is one of the surgeries performed on epileptic patients in King Edward Memorial (KEM) hospital here, Dr Sangeeta Rawat, head, Neurology told media today as part of the awareness programme.

"Anterior temporal lobectomy is the complete removal of the anterior portion of the temporal lobe of the brain. It is a treatment option in temporal lobe epilepsy for those in whom anticonvulsant medications do not control epileptic seizures," she said.

Twenty per cent of epileptica cases may benefit from surgery and "we have performed 150 surgeries in the last six years and most of them are today free from medicine and seizure," Dr Rawat said.

Unfortunately all the patients cannot undergo surgery to get rid of the problem and Abhishekh is even planning to go alone to US for his career prospective, she said.

The surgery will cost the patient in KEM around Rs15,000 Rawat said, reiterating that only 20% of the patients with  epilepsy are eligible for surgical procedures.  Epilepsy is a chronic neurological disorder characterised by recurrent seizures eminent neurologist from Wockhardt hospital and secretary of Indian Epilepsy Association (IEA) Dr Pravina Shah said.

Patients have physical reactions to sudden usually brief, electrical discharges in a group of brain cells and different parts of the brain can be the site of such discharges, she said.

Around 50 million people worldwide have epilepsy of which nearly 90% are found in developing regions, she said.

A community survey done in 18,000 households with 96,000 population few years back showed that five people out of every 1,000 population was epileptic and most of the patients have sudden attacks without any warning, Shah said.

In IEA's three-year-old 'Rural mission' it has been found that although people are aware of epilepsy, they said they do not have regular supply of medicines in rural hospitals and therefore, they are not able to continue medication and suffer  more, she said.

"Therefore, our rural camp now makes sure that the patients get regular treatment and medical supplies in the interior parts of the state and we began with Pen taluka in Raigad district," Shah said.

In KEM hospital which is considered as the largest epilepsy centre in Asia gets 40 to 50 new patients every day and 250 to 300 follow-up cases, she said.  The most common type of epilepsy — for six out of ten people with disorder is called 'idiopathic' epilepsy and till date has no known cause, Shah said.

When asked how many types of surgeries are done, she said, there are four types of surgery including ATL which was performed on Abhishekh.

When a women epilepsy patient gets pregnant, Dr Rawat said she should continue her treatment for epilepsy, "but usually we have observed that the family members do not allow them to continue."

"In our awareness programme we insist that if well managed, pregnant women with medication can have a normal child," Rawat said.

Talking about the tips to patients who inspite of medication affected by seizures, the IEA gave tips like the patients should wear helmets to protect the brain from skull fractures and bleeding due to sudden fall.

The patients have to follow good hand hygiene to avoid any self infection due to tapeworms. A recent report of World Health Organisation said that the tapeworm link with epilepsy was found to be far higher than thought, Shah said.

It was important to take doctors' advice regarding appropriate antenatal care and safe delivery, she said.