Laser ablation of epileptogenic foci
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Epilepsy is one of the most common neurological disorders. Approximately 65 million people worldwide suffer from epilepsy. 5% of the world's population has had an epileptic seizure at least once in their lives. Seizures are episodes of transient clinical manifestations of the abnormal electrical activity in the brain. In 30% of cases, epilepsy is resistant to drug therapy and a patient requires surgical treatment. Laser ablation of epileptogenic foci is considered one of the safest and at the same time most effective treatment options for epilepsy. It is performed under the MRI control.
Content
- Treatment principles
- How is the procedure performed?
- Treatment of epilepsy in Germany
- Arrangement of treatment
Treatment principles
Certain areas of the brain have epileptic activity and are the cause of seizures. The problem can be completely solved by removing these areas. To accomplish this, laser ablation is used. With the help of a laser, a small part of the brain is destroyed.
Ablation of epileptogenic foci is indicated when the following two conditions are present:
- Pharmacoresistant epilepsy. This is a form of the disease that cannot be controlled with medications. Such cases represent about 30% of the total population of patients.
- Precisely defined area of the brain that is the source of pathological activity.
Laser ablation is an effective alternative to conventional neurosurgery that requires craniotomy, significantly prolongs the period of postoperative recovery and increases the risk of complications.
Laser ablation increases the cost of treatment. Instead, the operation becomes safer and remains the same effectiveness. The postoperative recovery is shorter; tolerability of the postoperative period is better.
How is the procedure performed?
The operation is performed under general anesthesia. Doctors make several small holes in the patient’s skull. They use for ablation a 1.65 mm diameter probe, so tissue damage is minimal. A doctor monitors the progress of the procedure with the help of real-time MRI.
Characteristics of the procedure:
- Average laser exposure time is about 10 minutes
- Ablation zone is 2-3 cm
- Patient’s stay in the hospital is limited to 1 day
- A patient does not require an intensive care unit
- Long-term effects of the procedure are the same as after the open operation
Laser ablation has obvious advantages over open surgery: low risk of complications and shorter rehabilitation period, possibility to treat patients with concomitant somatic disorders.
The Visualase™ system is designed for performing MRI-guided laser ablation with maximum accuracy, providing patients with a number of additional benefits. Among them are performing surgery through a 3.2 mm hole in the skull, avoiding shaving the head before surgery, and discharge from the hospital the day after the procedure. The flexible catheter of the Visualase™ system allows the neurosurgeon to destroy epileptogenic foci in any part of the brain. MRI control of the procedure is used instead of the conventional visual examination of the surgical site, providing the doctor with more accurate volumetric images of the central nervous system.
The Visualase™ system received FDA approval more than 10 years ago, in July 2007. Following the SLATE trial (the pivotal clinical trial of Stereotactic Laser Ablation for Temporal Lobe Epilepsy) in patients over 18 years with temporal lobe epilepsy, laser ablation using the Visualase™ system became the "treatment of choice" for patients with drug-resistant temporal lobe epilepsy. In April 2018, the technique won the additional CE Mark approval in the European Union.
Treatment of epilepsy in Germany
In most countries laser ablation of epileptogenic foci is not performed. This treatment is available only in countries with highly developed medicine, where clinics are properly equipped and doctors are qualified enough and have experience of conducting such operations.
We offer you treatment in the best German clinics. Laser ablation will allow you or your child to get rid of epileptic seizures for good. Advantages of the operation in a German clinic:
- The best doctors: this is one of the reasons why patients from all over the world prefer to undergo treatment in Germany
- Safety: you will be sure that a doctor will not damage functionally significant brain areas and the neurological deficit will not arise after the operation
- Experience: since treatment of epilepsy in Germany by laser ablation is carried out frequently, doctors’ extensive experience guarantees desired results.
Treatment of epilepsy by laser ablation is performed by neurosurgeons of the Beta Clinic in Bonn. The clinic has a department of neurosurgery and interventional radiology. It admits about one thousand patients with epilepsy annually. About 300 of them fail to respond adequately to pharmacotherapy. They are subject to surgical treatment.
Bundeswehr Academic Hospital Berlin offers comprehensive medical programs that include preparing the patient for the surgical treatment of epilepsy, the operation itself and measures for recovery after the intervention on the brain. Operations using neuronavigation systems are one of the specialization areas of the Department of Neurosurgery.
International Neuroscience Institute Hannover provides surgical treatment for epilepsy in adults and children. In addition to neuronavigation, brain mapping systems are used here, which reduces the risks of neurosurgical interventions even more. The Head Physician of the Department of the Adult and Pediatric Neurosurgery, Prof. Dr. med. Dr. h. c. Madjid Samii, is the Honorary President of the German Society for Computer- and Robot-Assisted Surgery.
Germany is one of the countries that shifts from performing open surgeries towards less traumatic and safer minimally invasive surgeries. For more than 10 years, laser ablation has been used here to destroy foci of epileptic activity in the brain.
Arrangement of treatment
Specialists of Booking Health would be glad to organize treatment in Germany for you. The advantages of collaboration with us include:
- Selection of a clinic where laser ablation of epileptogenic foci is performed with the highest efficiency and minimal risk of complications.
- Communication with administration of the clinic and the attending physician. We will help you to establish communication before the procedure and after the completion of the treatment program.
- Assistance in purchasing and transporting drugs to your native country.
- Reduced cost of treatment. The price can be lower by up to 50% due to the absence of additional coefficients for foreign patients.
- Planning of the treatment program based on the previous diagnostic tests results. We will translate your medical records into German, and you will not have to repeat the same tests.
- You will be treated at a convenient time. We will reduce the waiting period.
- We will provide full control of your funds. You will know exact details of all payments. The remaining amount will be returned to your bank account once the medical program is completed.
- If necessary, we will organize an additional diagnostic examination, treatment or neurological rehabilitation in Germany.
Our team provides the highest level of service. We will book flights for you and an accompanying person, take care about accommodation in the nearest hotel. We will help you obtain documents for traveling abroad and will guide you during your stay in Germany. We will pick you up at the airport and arrange transfer to the clinic and back to the airport after the treatment program completion. At the clinic, you will be accompanied by a interpreter.
Choose treatment abroad and you will for sure get the best results!
The Booking Health portal presents 14 German clinics specializing in epilepsy treatment with MRI-guided laser ablation of epileptic foci
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Centers for Disease Control and Prevention
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