Epilepsy surgery comes as a relief to `drugged' patient

bangalore: he spent most of the day in a drugged induced stupor. barely able to lift his head due to the heavy doses of medication that he took for his epileptic attacks, it seemed like the end of the road for the eight-year-old suresh (name changed). that was when his doctors at the manipal institute of neurological disorders (mind) here decided to perform surgery on him.epilepsy surgery has for long been a subject of debate even among the first cousins -- neurologists and neurosurgeons. surgery, in fact, pre-dated medication for epileptic attacks. still, the divide ran deep and in countries like india it still has to catch on as a viable alternative. in the south, only a few centres like nimhans (bangalore) and sri chittira tirunal (thiruvananthapuram) carry out surgeries routinely on certain categories of epileptic patients. the seriousness of suresh's problem was detected by manipal hospital consultant neurologist dr m.s. manjunath who then teamed up with colleague and consultant neurosurgeon dr sujay rao to look for a treatment modality. ``when he came to us he was like a zombie, unable to even lift his head. he used to be drowsy and inattentive almost like a drug addict. the heavy dosage of anti-epileptic drugs almost since birth had led to this state. he used to get upto 15 seizures a day and the toxicity of the medicines was killing him,'' says dr rao. with the coming of the mri and a better understanding of neurophysiology, dr rao says that there has been a better understanding of epilepsy. an equipment for long-term monitoring and eegs showed the mind team the focal point of the epileptic attacks. ``it was then that the team got together to carry out the surgery and remove the portion of the brain which was giving rise to the attacks. at the same time we had to ensure that we did not cause any other damage and alter any other brain functions,'' dr rao explains. in suresh's case the focus was the hippocampus which is deep inside the human brain and usually controls the vegetative functions. says dr rao, ``the removal of the hippocampus could sometimes lead to hyper sexuality and as a result post-operative follow-up is of utmost importance in such cases. after care is also very necessary because one needs to observe whether after the removal of the hippocampus any other part of the brain does not take up the role of the secondary generator.'' dr rao cautions that not all epilepsy cases are fit for surgery. he states that those children with complex partial seizure syndrome, adults with full-blown violent epileptic fits and those with rassmussen's disease could be helped by surgical procedures. also some with multiple sclerosis could benefit. when last seen suresh was busy running in and out of the hospital's rooms, sometimes even snatching a biscuit from a fellow patient. more importantly, his epileptic attacks have also been shown the door. he will be on a much milder dose of medication for the next six months. by then hopefully, he would be reaping the benefits of surgery that has been known for long, but which many hesitate to use.