Jun
17
2011
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SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – RISK-BENEFIT DISCUSSION WITH YOUR PHYSICIANS

SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – RISK-BENEFIT DISCUSSION WITH YOUR PHYSICIANS
Discussion of the possibility of surgery and its risks and benefits should be an ongoing process. Having identified a focus and its location, surgery can become a more serious consideration, and a more detailed discussion of its risks and benefits is possible. The risks will depend on the area to be removed. Surgery is most often performed to remove a focus from the frontal or temporal lobes of the brain, areas from which large amounts of tissue can usually be safely removed without major complications.
As with any operation, there is, of course, a risk of dying or suffering major complications of anesthesia. While the consequences of such a complication could be great, the chances of a major anesthetic complication’s occurring are in the range of less than one per one thousand. Infection also is always a risk; so is bleeding or clotting of a blood vessel. All these are potentially serious and capable of causing additional brain damage. Fortunately, these complications occur infrequently.
Generally, as noted, frontal and temporal lobe removals are considered by neurologists and neurosurgeons to be “safe” procedures, but as with any decision-making process, the risks and their magnitude must be weighed against the possible benefits and the chances of those benefits occurring. What are the benefits of the focal operations? The maximum benefit would be freedom from seizures for your child—freedom from taking anticonvulsant medicine and freedom from neurologic deficit due to the surgery. This is everyone’s goal. What are the chances of that occurring? Surprisingly, it is difficult to give numerical answers to this question. Surgical centers often quote 60-75 percent “good outcomes.” This means that perhaps 50 percent will be cured of their seizures, another 10—25 percent will have substantial decrease in the frequency of their seizures, and about 25 percent—one in four—will not be helped at all.
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Discussion of the possibility of surgery and its risks and benefits should be an ongoing process. Having identified a focus and its location, surgery can become a more serious consideration, and a more detailed discussion of its risks and benefits is possible. The risks will depend on the area to be removed. Surgery is most often performed to remove a focus from the frontal or temporal lobes of the brain, areas from which large amounts of tissue can usually be safely removed without major complications.
As with any operation, there is, of course, a risk of dying or suffering major complications of anesthesia. While the consequences of such a complication could be great, the chances of a major anesthetic complication’s occurring are in the range of less than one per one thousand. Infection also is always a risk; so is bleeding or clotting of a blood vessel. All these are potentially serious and capable of causing additional brain damage. Fortunately, these complications occur infrequently.
Generally, as noted, frontal and temporal lobe removals are considered by neurologists and neurosurgeons to be “safe” procedures, but as with any decision-making process, the risks and their magnitude must be weighed against the possible benefits and the chances of those benefits occurring. What are the benefits of the focal operations? The maximum benefit would be freedom from seizures for your child—freedom from taking anticonvulsant medicine and freedom from neurologic deficit due to the surgery. This is everyone’s goal. What are the chances of that occurring? Surprisingly, it is difficult to give numerical answers to this question. Surgical centers often quote 60-75 percent “good outcomes.” This means that perhaps 50 percent will be cured of their seizures, another 10—25 percent will have substantial decrease in the frequency of their seizures, and about 25 percent—one in four—will not be helped at all.
*157\208\8*
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Written by admin in: Epilepsy |

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