Epileptology is a sub-speciality of Neurology, focussing on evaluation and
management of difficult to treat or complex
epilepsy cases where seizures were not controlled despite starting
anti-epileptic medications prescribed by physician,
paediatrician or Neurologist.
Epileptologist is trained in detailed evaluation and management of complex
paediatric as well as adult epilepsy cases,
and plays the main role in precisely finding out whether there is
epileptogenic focus in the brain which can be
surgically removed to permanently cure epilepsy.
Drug resistant epilepsy can be defined as failure of adequate trials of two
tolerated, appropriately chosen and used
antiepileptic drug schedules (whether as monotherapies or in combination) to
achieve sustained seizure freedom.
There are 70 million persons with epilepsy (PWE) worldwide, nearly 12 million
PWE are expected to reside in India; which
contributes to nearly one-sixth of the global burden. One million Indians
have medically refractory seizures. An
approximate 5 -6 lakh people are candidates for epilepsy surgery in India.
In 20-30% of patients diagnosed to be having epilepsy, drugs cannot control
epilepsy. Most of the time, these patients
have something visibly abnormal in their brain. So, if we can surgically
remove the abnormality which is visible on MRI
brain, we can practically cure epilepsy and improve the quality of life of
person affected with epilepsy.
If your seizures are controlled on one or two drugs, then there is no need
for surgery. However, when you have to take
more than two medications and you continue to have seizures, surgery is
rational choice due to the problems associated
with recurrent seizures such as:
Poor quality of life
Injuries
Social ostracism
Marital issues
Care-giver burden
Adverse effects of medication
Sudden unexpected death
Even financially, if you are on two medications, your monthly
maintenance comes to around 5000/ month i.e.
Rs.60,000 annually. The average cost of epilepsy surgery with all
investigations, hospitalization is close to
2.5-3 lakhs.
