Living with epilepsy can be highly challenging. This is a medical condition that can be controlled with medications in most cases, but it might not be useful for all patients due to severe side effects. It is estimated that up to 30% people who have epilepsy face this issue, and in such cases, surgery might be considered as an option.

This condition typically results in seizures which is a result of sudden electrical activity in the brain. So, certain complicated epilepsy operations on the brain can help patients with their seizures and contain their symptoms.

The goal of epilepsy surgeries involves removing part of the brain that causes these seizures and disrupting parts of the nervous system in the brain that contribute to the same. The procedure also involves the installation of a device that helps control the side effects of epilepsy.

When is surgery not an option for epilepsy?
Doctors would accurately identify the part of the brain that is causing seizures as the first step. These parts are known in medical terms as the  seizure  focus. This area should not be related critical functions of the brain like movement, sensation, and language involved   else surgery would not be possible.

Surgery is not viable when seizures are severe and impair bodily movement or if the patient has serious medical conditions (like cancer or heart diseases).

Common Surgery Options Available

Lesionectomy: This is one of the most commonly used procedures. This form of surgery involves the surgeon removing brain lesions from the brain or areas of injury due to malformed blood vessels or tumors. These injuries can often cause seizures and epilepsy and can be treated effectively with lesionectomy.
Lobe resection: This is another form of treatment which is possible only if the epilepsy is located in one of the four parts of the brain   the temporal lobe. It is quite common in younger people and can easily be treated by expert neurosurgeons by removing the brain tissues that are causing epilepsy.
Multiple Subpial Transections: While the above methods involve cutting out brain tissues, sometimes such surgeries just might not be possible due to other complications. If the parts of the brain cannot be cut out, surgeons tend to adopt Multiple Subpial Transections. This procedure can help control seizures without requiring cutting out parts of the brain. Small intersections are made in the brain to disrupt the impulses from affected brain cells that cause seizures, and they do not affect normal brain activity. It helps leave all abilities intact in patients and aids in treatment very effectively.
So, if you are just fed up with dealing with the seizures, consult your doctor who will be able to advise on the course of action depending on the history and medical condition.

Epilepsy - Is Surgery An Option?

Migraine is a severe form of headache wherein, the excruciating pain is accompanied by an extreme sensitivity to sound and light; you also experience nausea. The headaches usually affect either side of the head and are throbbing in nature. Hot flashes, numbness of limbs and blind spots in the eye; these are often considered as warnings. In certain cases, migraines can cause blackouts that can range from a few seconds to a few minutes.

Migraine occurs in four stages:

Pro-drome (symptom indicative of an onset of an illness)
Aura (visual auras including blurred vision)
Headache
Post-drome (the residual effects of migraine characterized by fatigue and lethargy)
But the occurrence of these stages varies across individuals. The causes of migraines aren t specifically understood. It may be due to the interaction of the brain stem with the trigeminal nerve, which is an important pain pathway of the brain. Imbalances in hormonal levels or in the levels of neurotransmitters such as serotonin may also prove to be a causal factor.

Symptoms

Migraine may be triggered due to stress, physical exertion, and excess intake of alcohol or food additives such as MSG (Monosodium Glutamate). Changes in the environment and sleeping patterns may also be probable culprits.

Migraine can be easily distinguished from regular headaches, given the fact that migraines last longer and are rather severe in nature with pain felt in one part of the head. Most people experience the  Aura stage where they have visual flashes right before headache. Nausea, eye pain or sensitivity to light and sound are other factors helpful in distinguishing migraine from other headaches.

Symptoms can occur a while before headache, immediately before headache, during headache and after headache. Although not all migraines are the same.

Typical symptoms include:

Moderate to severe pain, usually confined to one side of the head during an attack, but can occur on either side of the head
The pain is usually a severe, throbbing, pulsing pain
Increasing pain during physical activity
Inability to perform regular activities due to pain
Feeling sick and physically being sick
Increased sensitivity to light and sound, relieved by lying quietly in a darkened room
Some people experience other symptoms such as sweating, temperature changes, tummy ache and diarrhea.
Complications in migraine may include:

Chronic migraine which last up to 15 days or more
Status Migrainosus where the attacks last for over 3 days
Migrainous infarction where the aura lasts longer than it should, cutting blood supply to the brain. 
If you wish to discuss about any specific problem, you can consult a neurologist.

Migraine - Know The Causes and Symptoms!

Both schizophrenia and autism are considered to be neurological disorders resulting from atypical neural development, occurring due to a variety of causes. Both these disorders have a genetic predisposition that may be due to environmental factors. However, there are a few basic differences between the two disease conditions.

Autism is also known as Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder characterized by a spectrum of abnormal behaviour. They include persistent deficits in social communication and interaction, along with restricted and repetitive patterns of behaviour, interests or activities.

Signs of autism in babies

By 6 months - No social smiles or other warm, joyful expressions; limited to no eye contact
By 9 months - No sharing of vocal sounds
By 12 months - No babbling or use of gestures to communicate; not responding to one s name when called
By 16 months - No use of words
By 24 months - No meaningful or two-word phrases
Signs of autism at any age

Avoids eye contact and wants to be alone
Finds it difficult to understand other people s feelings
Speaks very less or has delayed language development
Echolalia - Repeats words or phrases
Cannot accept change in routine or surroundings
Performs repetitive behaviours like flapping or rocking
Has restricted interests and hobbies
Reacts unusually intense to sounds, smells, tastes, lights, colours etc.
Schizophrenia
Schizophrenia is a neuropsychiatric disorder that begins during late adolescence and early adulthood. It is characterized by delusions, hallucinations, disorganized speech and behavioural changes that cause social and occupational dysfunctions.

Signs of Schizophrenia

The symptoms of schizophrenia are usually observed between ages 16 and 30, such as e.g. delusions, hallucinations, thought disorders, movement disorders etc.
Delusions are false beliefs of the patient that may take many forms like delusions of persecution or grandeur. You may feel somebody is controlling you or may think you have extraordinary powers and abilities.
Hallucinations are when the patient hears voices more than seeing, feeling, tasting or smelling random things, which are not actually there.
Thought disorders are when the person jumps from one subject to another for no logical reason.
Some negative symptoms i.e. these are symptoms which are normally present in a healthy individual, but are absent in a schizophrenic patient. E.g. absence of facial expressions, lack of motivation etc.
Cognitive symptoms affect the individual s thought process. They can be positive or negative based on their expression. E.g. poor  executive functioning  which deals with the ability to understand information and make decisions using them, finding it difficult to focus etc.
Although both Autsim spectrum disorder and schizophrenia are interlinked in their causes and neurological background, the symptoms for each disorder are different. 
Consult your physician if you happen to observe any of these symptoms in your loved ones.

Autism & Schizophrenia - What Is The Difference?

Sleep is known to most as a period of rest and relaxation, but there are multiple disorders which are associated with sleep too. Hypersomnolence or hypersomnia is one of the most common sleep disorders. This is characterised by excessive daytime sleepiness and prolonged periods of sleep at night. They wake up fresh in the morning, but can easily go back to sleep any time of the day without feeling strained or tired. There is again no freshness associated upon waking up. Funny as it may sound, they can doze off even during a meal or in the middle of a conversation.

Causes: This condition is most common in men and in the early adolescent days.

There is no underlying cause that has been identified, though there is a genetic predisposition.
People with history of head trauma are more affected
People with anxiety, depression, bipolar disorders, epilepsy, and other mental disorders are also more likely to be affected
People with sleep apnea often are hypersomnolence
Restless legs syndrome, narcolepsy
Neurodegenerative disorders like Parkinson s and Alzheimer s tend to sleep more.
Symptoms:

Sleeping for longer hours at night time
Excessively sleepy during daytime
Able to doze off anytime during the day
Inappropriate and involuntary sleeping pattern
Having difficulty getting out of bed after waking up, even after prolonged sleep
Feeling of disorientation
Feeling agitated, anxious, lethargic, and irritated
Impaired cognition and memory
All these lead to extreme state of drowsiness
Increased tendency for hallucinations
Reduced appetite and even weight loss in some people
There is restlessness, reduced pace of thinking and speaking
Overall reduced energy levels
Social interactions are affected including work life, social functions, etc.
Diagnostic criteria:

If a person happens to sleep more at night or falls asleep during the day easily for more than 3 times a week, it is usually concerning.
The added feature of no tiring physical activity can also lead to suspicion
In acute cases, these symptoms are present for at least a month and in chronic cases, it could be seen for up to 3 months
It cannot be explained by lack of sleep on a regular basis
One or more of the above conditions could be present, which can help in making the diagnosis
Treatment:
Most cases of hypersomnia would need treatment only to improve their energy levels and improve the quality of life. Very often, treating the underlying condition can lead to improvement of hypersomnia. The tired, lethargic, restless feeling affects the overall performance of a person, leaving them with a lowered self-esteem. Brain stimulating drugs like amphetamines are used to improve daytime alertness and also reduce sleepy feeling during the day.


Hypersomnolence - How It Can Be Managed?

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

Migraine vs. Headache: know the difference

How to differentiate between a migraine and headache?

When you feel pain or pressure in your head, it may become difficult for you to assess whether you are experiencing a common headache or a migraine. Let's understand how different they are from each other.

A typical headache usually affects both sides of your head and varies from a mild to moderate pain. It can last from 30 minutes to up to a period of one week.

Some specific areas which get affected by a headache are:

  temples

  forehead

  back of your neck

Factors that trigger this headache type are a muscle strain, stress or anxiety. 

A migraine, on the other hand, is also a type of a headache which results in an acute throbbing sensation in one part of your head. Usually, migraine headaches are highly painful. Migraine pain makes it difficult for a person to carry out his/her daily tasks. Symptoms or signs associated with migraine attacks are:

  vomiting

  nausea 

  sensitivity to sound or light

  pain in the temples

  temporary loss of vision

  pain behind your ear or eye

What are the common causes of a migraine?

  hormonal imbalances in women - fluctuations in oestrogen, especially during menopause or pregnancy seem to trigger a migraine

  drinks like wine and extremely caffeinated beverages 

  foods such as salty foods, aged cheese as well as processed foods can trigger the migraine attack.

  medications - vasodilators such as nitroglycerine and oral contraceptives can intensify migraine pain.

How to treat a headache?

Fortunately, you can get rid of stress-induced headaches through over-the-counter treatments, which include:

  aspirin

  acetaminophen

  ibuprofen

How to treat a migraine?

If you experience migraine attacks less frequently, these medicines may give you quick relief:

  triptans, such as rizatriptan (Maxalt) or almotriptan (Axert)

  antinausea medicines, such as chlorpromazine (Thorazine), promethazine (Phenergan) or prochlorperazine (Compazine)

  non-steroidal anti-inflammatory drugs (NSAIDs), such as acetaminophen, naproxen sodium, aspirin or ibuprofen

Some preventive tips:

  make changes in your diet such as avoid such foods, including caffeine and alcohol which are believed to trigger headaches.

  you can also try muscle relaxation exercises, yoga or meditation to ease the migraine attack. 

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 8 Common Migraine Triggers You Must Stay Away From

Migraine Vs. Headache: Know the Difference

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