The neurosurgery department of the Tel Aviv Sourasky Medical Center performs complex neurosurgical operations for the treatment of epilepsy. Surgical intervention on the human brain is the highest skill of a surgeon.
The majority of patients with epilepsy are prescribed conservative treatment. However, statistics show that 20 - 30% of patients suffer from a form of epilepsy that does not respond to medication.
Why is surgical treatment inevitable in some cases? Symptoms of epilepsy that do not respond to medication are life-threatening. A seizure can occur at any time, in any place, leading to severe injuries. The monstrous muscle tension puts extreme stress on the heart, and seizures can lead to the aspiration of saliva and blood into the airways, while respiratory arrest disrupts acid-base balance, and the overexcitation of nerve cells can lead to their destruction, even to a comatose state. Even milder forms of the disease can lead to severe depression.
Medication-resistant epilepsy can be treated surgically.
The preoperative evaluation of patients requiring surgical treatment for epilepsy includes a detailed medical history and physical examination, modern imaging techniques (CT, MRI, video-EEG monitoring, PET, Single Photon Emission Computed Tomography (SPECT)), neuropsychological testing, and assessment of psychosocial functioning.
Candidates for surgical intervention are patients with medication-resistant forms, as well as those controlled by medications but with clearly localized brain damage, allowing for easy and rapid surgical cure. The key method is the use of high-precision imaging techniques – MRI, PET, SPECT, which allow for the precise identification of the pathological impulse area in the brain.
In complex cases, invasive EEG (electroencephalography) techniques are used. Electrodes are placed on one of the brain membranes or directly into the brain.
The goal of surgical intervention is to identify the abnormal cortical zone – the source of the pathological impulse and its precise removal. Initially, the area with visible structural changes is determined. Based on high-precision diagnostic techniques, structurally intact areas that are sources of seizure impulses are identified. The technique of choice is partial removal of the lobe of the brain, a section of the cortex, or the hemisphere, as well as techniques for severing connections between hemispheres and cerebellar-vagal stimulation. The most important task of the surgeon is to preserve the patient's personality, intellectual abilities, and emotional sphere as much as possible. Modern technology can detect small formations such as benign brain tumors, local atrophies, and pathological areas of the cortex. Targeted destruction and removal of deformities guarantee maximum preservation of the patient's mental functions.
The neurosurgery department of the Ichilov Medical Center occupies a prestigious place among the leading neurosurgical centers in world medicine. The trained staff of doctors, nurses, and support services, along with the availability of the most modern diagnostic and therapeutic equipment, enable Israeli doctors to successfully fulfill their mission – to restore people in the shortest time, giving patients a second chance at life and a full life.
- Epilepsy