About the Procedure
From Memorial Hermann Texas Medical Center:
Live Webcast of Resective Surgery for Refractory Epilepsy
Highly Effective Surgical Treatment of Epilepsy
While the majority of patients with epilepsy are managed well with medications, a significant number of patients – approximately 25 percent – do not respond well to pharmacological therapy. For many of these patients with pharmaco-resistant epilepsy, surgery may offer a positive outcome.
On December 20, at 5:30 p.m. CST, a resective surgical procedure performed at Memorial Hermann Texas Medical Center will be broadcast live in a global webcast. The surgery will be performed by Nitin Tandon, M.D., a neurosurgeon on staff at Memorial Hermann Texas Medical Center and assistant professor of neurosurgery at The University of Texas Medical School at Houston.
Resective surgery for epilepsy targets a specific part of the brain, where the seizures are thought to originate. Though the origin of seizures may be within the frontal, parietal or occipital lobes, medically refractory seizures typically originate deep within the temporal lobe. Patients with such seizures may benefit from a temporal lobectomy - a resective surgery in which scarring deep within the hippocampus, is removed.
Elaborate pre-operative testing is often needed to accurately determine the site of origin of the seizures. Such testing also makes it possible to minimize the likelihood of damage to the surrounding “eloquent” brain regions that control motor function and language.
“This advanced surgery has contributed so much to the quality of life for many patients,” says Dr. Tandon. “It is the final step in a complex process, a true team effort, beginning with the very first EEG through recovery.”
Mapping of the brain and localization of the area of the brain responsible for seizure onset sets the stage for the resective procedure. The candidate for the Dec. 20 surgery may undergo a detailed evaluation by 24-hour monitoring in the Memorial Hermann Epilepsy Monitoring Unit. This monitoring may be carried out with electrodes placed on the brain surface and/or within the brain to pinpoint scarring and identify potential functional areas at risk. If the planned resection is adjacent to parts of the brain involved in speech or motor function, the patient will also undergo cortical stimulation mapping with the implanted electrodes. This mapping will be reviewed during a video taped portion of the Webcast.
The pre-surgical evaluation is directed by Jeremy Slater, M.D., director of the Memorial Hermann Epilepsy Unit and associate professor of neurology at The University of Texas Medical School at Houston. The evaluation team will consist of a neurologist specializing in epilepsy (an epileptologist), a neuroradiologist, a neuropsychologist, a social worker and Dr. Tandon.
In addition to neuropsychological testing, the pre-operative evaluation employs CT (computerized transaxial tomography), MRI (magnetic resonance imaging), PET (positron emission tomography), MEG (magnetoencephalography) and SPECT (single photo emission computed tomography), all tests used to help locate the source of the seizures within the brain.
More than half of epilepsy patients who have resective surgery remain completely seizure free, and a total of 85 percent report a marked decrease in number of seizures and in severity. And yet, of approximately 300,000 candidates in the U.S. who could benefit from it, only about 3,000 will receive this proven, advanced neurosurgical procedure each year.
Serving as moderators of the live webcast will be Dennis Vollmer, M.D., chief of neurosurgery at Memorial Hermann Texas Medical Center and professor and chairman of neurosurgery at The University of Texas Medical School at Houston, and Jeremy Slater, M.D., director of the Epilepsy Monitoring Unit, Texas Comprehensive Epilepsy Program at Memorial Hermann Texas Medical Center and associate professor of neurology at The University of Texas Medical School at Houston.