epilepsy
EPILEPSY
Epilepsy is a clinical multiaxial diagnosis.
Epileptic seizure is a transient occurrence of signs/symptoms brought about by abnormal excessive or synchronous neuronal activity in the brain.
It is recommended that all patients having a first seizure be referred as soon as possible to a specialist to ensure accurate and early diagnosis and initiation of treatment appropriate to the needs of the patients.

Surgical Intervention

Surgery

  • May be an option for epileptic patients with seizures uncontrolled by pharmacological therapy and those with surgically remediable epileptic syndrome
  • Assess patient for the suitability of curative resective procedures before considering palliative procedures

Curative Resective Procedures

  • Anterior and medial temporal lobe resection
    • Approximately 70-90% of the patients become seizure-free
  • Resection of epileptogenic focus based on video-electroencephalogram recording of actual habitual seizures, neuropsychological tests, magnetic resonance imaging and positron emission tomography scan
    • Approximately 50% of the patients become seizure-free

Palliative Procedures

  • Corpus callosotomy - for uncontrolled frequent drop attacks
  • Subpial transection - for epileptic focus at eloquent functional area

Vagus Nerve Stimulation

  • Reduces frequency of seizures in patients refractory to pharmacological therapy and who are not suitable for surgery
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