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Epilepsy

Surgery option

03/18/2009

Question:

in what cases a person should consider surgery doctor said that medication just control and stoped further damage but it does not cured epilepsy is it true? if jerks in the case of J.M.E. are not completely stopped but they are not bothering the patient as they occour for a very less duration to notice but happen with some confusion in mind then is it means that still they are damaging brain

Answer:

Unfortunately for some people with epilepsy, currently available medications are unable to completely control seizures; in fact, for about 1 in 3 with epilepsy, seizures remain uncontrolled (this is called "medication resistant" or "refractory" epilepsy). Once an individual does not respond to trials of three different seizure medications, the chance for complete seizure control is less than 10 percent. Fortunately, there are other options available that may offer good chances for seizure control.

The first step in determining treatments for medication resistant epilepsy is to determine the epilepsy syndrome. There are two major categories of epilepsies: partial in onset and generalized in onset. In partial epilepsy, seizures begin in a specific or focal area of the brain. In the generalized epilepsies, seizures do not arise in a focal region of the brain, but involve the entire brain at seizure onset. The distinction between partial and generalized epilepsies is made by taking a complete history of the epilepsy (age on onset, types of seizures) and by using the electroencephalogram (EEG). The type of epilepsy affects the choice of medication because some seizure medications are not effective for generalized epilepsies. Thus, one of the potential reasons that an individual may continue to have seizures is the incorrect medication is chosen for the epilepsy type. Generalized epilepsies (like JME) cannot be treated with surgery as the seizures do not arise in one area of the brain.

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Response by:

David M Ficker, MD David M Ficker, MD
Associate Professor
College of Medicine
University of Cincinnati