Revolutionizing Spine Care…Changing Lives

A Promising New Procedure for Treating Epilepsy

Even though more than 65 million people worldwide and 3 million Americans suffer from epilepsy, a neurological disorder of the brain that causes seizures, very few of them talk about the condition. This suggests the presence of a stigma, dating back to the dawn of modern medicine that is based on a misunderstanding of the condition.

Many well-known, brilliant and highly successful people have had to deal with the effects of epilepsy. Here are eight famous people who suffered from these brain seizures and still managed to change the world.

  • Vincent Van Gogh
  • Neil Young
  • Edgar Allen Poe
  • Theodore Roosevelt
  • Lewis Carroll
  • Charles Dickens
  • Prince
  • Florence Griffith Joyner

According to the Epilepsy Foundation, “epilepsy is a chronic disorder, the hallmark of which is recurrent, unprovoked seizures. Many people with epilepsy have more than one type of seizure and may have other symptoms of neurological problems as well.”

Although the symptoms of a seizure can affect any part of the body, “the electrical events that produce these symptoms occur in the brain making it the source of epilepsy,” according to the foundation. Having seizures and epilepsy can affect one’s safety, relationships, work, driving and so much more.

“Public perception and treatment of people with epilepsy are often bigger problems than actual seizures.”   

An Expert on Epilepsy

As a one of the newer members of the Texas Back Institute team of internationally recognized spine and neurological specialists, Dr. Akwasi Boah is a neurosurgeon with extensive experience in research and treatment of brain disorders, including epilepsy. His clinical training and exemplary surgical expertise make him an excellent source for explaining the current and future treatments of this condition.

“Epilepsy is a disorder where the cells of the brain, which are also known as neurons, are temporarily disrupted from their usual activities,” Dr. Boah said. “This can result in many different kinds of seizures, some of which can include extreme convulsions where the patient’s arms and legs are violently shaking and eyes roll back. There are also more subtle variations of seizures, which can include repetitive movements, laughing spells, crying spells and other less-obvious actions.

“Over time, this condition has a cumulative cognitive effect. The more seizures a person experiences the greater the cognitive impact. It can also affect how normal neurologic functions are carried out. Walking, talking and “executive functions” – those skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully – are all affected by these seizures. In extreme cases, there is a risk of death.”

What Causes Epilepsy?

There are many different factors that can lead to this condition. Dr. Boah outlined a few.

“Lesions in the brain can cause seizures,” he said. “Capillary malformation in the brain can also contribute to this condition. Aneurisms, infections in the nervous system, trauma to the system, metabolic and congenital disorders and sometimes prior surgery can all lead to the onset of epilepsy.

“Some people don’t know that they have epilepsy. A one-time seizure event can uncover the underlying cause of the condition.”

Current Treatments for Epilepsy

At this time the primary treatment for epilepsy is through the use of anti-seizure medications.

“Most neurologists manage this condition with medications, where the number of seizures is reduced and the threshold for these events is much higher, making them less likely to occur. In most cases, this is effective treatment, but not always,” Dr. Boah said.

Neurosurgeon Akwasi Boah

“As a neurosurgeon, when I observe a patient who is unresponsive to these medications, I pursue surgical treatments. We try to determine what is causing these seizures and, if possible, correct this. For example, if a lesion on the brain is the cause, we are able to perform a procedure known as an electroencephalogram to determine the exact location of the seizures. In some cases, we can simply remove that which is causing these neurological events.

“In some cases, the seizures are poorly localized, meaning that they are firing from all over the brain. In this scenario, we perform a procedure known as a vagal nerve stimulator, which involves sending a mild electrical pulse to the brain via the vagus nerve. In other cases, we ‘map out’ the brain with cortical grids and when a determination is made as to the location of the seizure, we perform a procedure called a “lobectomy,” which is the surgical removal of a lobe in the brain.”

A Promising New Treatment on the Horizon

A recent article published in “Science Daily” examined a new approach to dealing with epilepsy – an MRI-guided, laser ablation surgery. This procedure is minimally invasive, meaning it requires a very small incision, and has proven to be an effective treatment for medial temporal lobe epilepsy (MTLE), a common form of drug-resistant epilepsy. Dr. Boah explained how this procedure works.

“I was privileged to see some of the early work on this procedure, observing patients who were treated, and it is really an amazing process! Medial temporal lobe epilepsy is one of the most difficult forms of the condition to treat and, as a result, neurosurgeons will often get involved.

“The typical surgical approach to this condition involves performing a craniotomy (a removal of part of the skull) where a ‘window’ is created in the skull. The membrane covering the brain is opened and the temporal lobe and part of the hippocampus are removed. This is a classic anatomic operation and, as with all surgery, has many risks. This new laser treatment substantially reduces the risks because it is minimally invasive and MRI-guided.

“While the craniotomy approach has been around for decades, this MRI-guided, laser ablation procedure is about seven years old. It has gone from being in its testing stage to wider use among neurosurgeons who treat epilepsy.

“This procedure is very promising for several reasons. First, if MTLE can be treated without opening the skull, everyone – patients and surgeons – would prefer this. Plus, if it is proven that the long-term benefit is the same or better as the more risky operation, it will become even more popular.

“Thus far the data on the long-term seizure control of this laser ablation procedure is very promising. If this continues to be shown as an effective treatment for this very difficult condition, it will be a game-changer. “

If you would like to hear the complete interview with Dr. Akwasi Boah, click on the SpineTalk podcast.

If you or a family member suffers from epilepsy, Contact us for an appointment with Dr. Boah or our other neurosurgeons at Texas Back Institute.

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