A ten-year-old woman who had suffered recurrent seizures since infancy has change into seizure-free following specialised epilepsy surgical procedure at Paras Well being Gurugram. The kid had continued to expertise breakthrough seizures regardless of remedy with seven anti-epileptic drugs, affecting her improvement, studying, progress and total high quality of life.
She was delivered to the hospital’s Neurology OPD by her mom with a historical past of seizures for the reason that age of 10 months. Following detailed neurological analysis, she was identified with multidrug-resistant epilepsy brought on by left mesial temporal sclerosis, with a part of the neocortex additionally recognized throughout the seizure-generating zone.
Superior Planning Guides Surgical procedure
A multidisciplinary epilepsy crew led by the Neurology and Neurosurgery departments undertook the case. The crew included Dr (Prof.) M. V. Padma Srivastava, Chairperson-Neurology; Dr Puneet Rana, Director-Neurosurgery; and Dr Surbhi Pande, Director-Nuclear Drugs, at Paras Well being Gurugram.
Superior investigations, together with epilepsy-protocol MRI with neuronavigation, Diffusion Tensor Imaging (DTI) and PET scans, have been used to determine the seizure-producing space whereas defending vital mind capabilities. Docs stated the delicate and difficult-to-localise seizure focus made surgical planning significantly difficult.
Dr Padma Srivastava stated drug-resistant epilepsy can have an effect on a baby’s mind improvement, training, behaviour and future potential past the seizures themselves. She added that rigorously chosen sufferers might profit considerably from surgical procedure when the seizure-producing zone is precisely recognized by way of specialised investigations and multidisciplinary planning.
Dr Puneet Rana stated the process was technically demanding due to the issue in localising the epileptogenic focus. He highlighted the position of neuronavigation and intraoperative electrocorticography (ECoG) in safely figuring out and eradicating the seizure-generating tissue whereas preserving vital mind capabilities.
Rana carried out the practically four-hour process utilizing neuronavigation. It concerned a minimally invasive 1.5 cm corticectomy adopted by selective amygdalohippocampectomy below steady ECoG monitoring. Particular care was taken to protect the language centres and very important blood vessels supplying deeper mind constructions.
The affected person recovered with out neurological deficits or issues and was discharged 5 days later. Throughout follow-ups, she has remained seizure-free, with medical doctors planning gradual discount of her anti-epileptic medicines primarily based on her progress. The treating crew famous that solely a proportion of epilepsy sufferers are appropriate for lesionectomy-based surgical procedure, however well timed intervention in rigorously chosen circumstances can provide long-term seizure management and enhance high quality of life.
