What are the Different kinds of epilepsy in children's

To understand epilepsy, you first have to understand how the brain functions. The brain controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that normally communicate with each other through electrical activity.

Epilepsy is defined as two or more seizures that occur without a specific cause. Seizures are altered behavior that occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.

Different kinds of epilepsy are classified according to:

·         Signs and symptoms

·         The child's age when they begin to occur

·         The child’s EEG pattern

·         Neurologic findings on examination

·         Special kinds of imaging (x-ray-type) tests, including magnetic resonance imaging (MRI) and computerized tomography (CT) scans

Seizure Classifications

Focal Seizures

These seizures take place when abnormal electrical brain function occurs in one or more areas of one side of the brain. If the child does not lose consciousness throughout the seizure, the seizure was previously classified as simple. If the child loses consciousness or does not respond appropriately, the seizure was previously classified as complex.

Focal seizures may include one-sided jerking movements of the arms or legs, stiffening, eye deviation to one side or twisting of the body. Sometimes these symptoms follow these other signs:

·         Seeing visions

·         Hearing noises

·         Tasting and smelling things

·         Dizziness

·         A rapid heart rate

·         Dilated pupils

·         Sweating

·         Flushing

·         Stomach fullness

·         Psychic symptoms such as a sense of deja-vu, distortions, illusions and hallucinations

Generalized Seizures

These seizures involve both sides of the brain. As a result, the seizures are less variable than focal seizures.

Typically, they involve brief staring spells; sudden, quick muscle jerks; generalized and rhythmic jerking of the extremities; generalized stiffening episodes; or generalized stiffness followed by rhythmic jerking of the extremities or a sudden loss of muscle tone, resulting in a head drop or sudden fall to the ground.

Causes

Fever (febrile seizures) are caused by fever in children age three months to five years of age, with no other underlying neurologic problems present. Febrile seizures are common and occur in 2-5% of all children. Simple febrile seizures are brief (usually less than five minutes), generalized convulsions that only occur once in the course of an illness.

Metabolic or chemical imbalances in the body may also cause seizures. Conditions that prompt seizures include hypoglycemia (low blood sugar), hypo/hypernatremia (too little or too much sodium in the blood) and hypocalcemia (too little calcium). Meningitis or encephalitis (brain infections) may also induce seizures. Other acute problems that can cause seizures include toxins, trauma and strokes. In children with epilepsy, a common reason for sudden increase in seizures is that the youngsters are not taking their medications as directed.

Trauma at birth or brain abnormalities such as tumors can also be the source of seizures. A lack of adequate oxygen near the time of birth, trauma, infection and stroke can induce a seizure. Sometimes the seizures appear suddenly, although the brain abnormality may have been present for a long time.

Seizures can also develop as a result of a neurodegenerative disease. While neurodegenerative diseases are rare, they can be devastating.

Diagnosis

The best tool the doctor has to evaluate the spells is the child's history. This includes knowing what happened immediately before the seizure, the first indication that something was wrong, a complete description of the event, the level of responsiveness of the child, how long the seizure lasted, how it resolved and what the child did after the event. All or some of the following tests may be used:

Blood tests

·         Electroencephalogram (EEG) – A procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp.

·         MRI – A diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.

·         CT scan – A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices) of the body, both horizontally and vertically. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general x-rays.

·         Lumbar puncture (spinal tap) – A special needle is placed into the lower back into the spinal canal. This is the area around (but not into) the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problem. CSF is the fluid that bathes your child's brain and spinal cord.

Medication

Many types of medications may be used to treat seizures and epilepsy. Epilepsy medications are selected based on:

·         The seizure type

·         Child’s age

·         Side effects

·         Consistent use of the medication

Discuss your child's medication side effects with their physician. While your child is taking medications, different tests may be done to monitor the effectiveness of the medication. These tests may include the following:

·         Blood work: Frequent blood draws testing may be required to check the level of the medication in the body. Based on this level, the physician may increase or decrease the dose of the medication to achieve the desired level. This level is called the "therapeutic level," and is where the medication works most efficiently. Blood work may also be done to monitor the effects of medications on body organs.

·         Urine tests: These tests are performed to see how the child's body is responding to the medication.

·         EEG

You should weigh the risks and benefits of therapy versus the risks of a subsequent seizure before your child begins taking a medicine. Treatment is generally not started after the first seizure in children.

While reports vary, the recurrence risk after the first seizure, if it occurred for no apparent reason, is approximately 40%. The majority of recurrent seizures occur soon after the first event — 50% occur within six months.

The use of only one drug is preferable if possible, as approximately 70% of children become seizure-free on therapy with one medication. Another 15% of children become seizure-free on a combination of several. The final 15% have epilepsy that does not respond to medication.

Other Treatments

·         Ketogenic diet – A strict, high-fat diet useful for generalized seizures that don't respond to medication.

·         Vagal nerve stimulator – A surgically implanted wire around the vagal nerve hooked to a pacemaker device in the chest that is programmed to give intermittent stimulation to the vagal nerve. This device is FDA-approved as adjunctive therapy for partial seizures in children over age 12. However, some researchers believe it’s useful for younger children, as well as in children with intractable generalized seizures.

·         Epilepsy surgery – For some patients, particularly those with focal seizures that don't respond to medication or with identifiable lesions on head imaging studies, epilepsy surgery may be the best treatment.

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Most Advanced Treatment of various types of Brain and Neurological Disorders

The main line of treatment is with antiepileptic drugs, which are effective in controlling seizures in 70%-80% of patients with epilepsy. There are several antiepileptic medications. Since certain medications are much better for some seizures, the choice of the medication should be made by a physician who is familiar with these medications. If possible, the child should be evaluated in a center specializing in epilepsy. If this is not feasible, usually pediatric neurologists have training in epileptic disorders and are a good source for a referral.

When antiepileptic drugs fail to control the seizures, the patients may improve with surgical procedures.

Who is a candidate for epilepsy surgery?

Surgery is indicated in a small group of children.

It usually takes the failure of two or three antiepileptic medications before a child would be considered as a potential candidate for surgery. In general, this happens at least after two or three years of continuous treatment with medications. The failure might be due:

1.   to a resistance to the antiepileptic medications that are available,

2.   to the presence of intolerable side effects to the antiepileptic medication,

3.   or to a combination of both.

Since surgical procedures might be very effective in some children, once it is clear that the child's epileptic disorder is not responding to treatment with antiepileptic medications, surgery should be considered. Young age is not a contraindication for surgery, and there is no benefit in waiting for the child to be older. In fact, there is considerable evidence that the younger a child is at the time of surgery, the better his/her potential will be for good function after the surgery. There is a certain degree of plasticity in the brain that helps with the recovery of functions that can be damaged at the time of surgery. This plasticity is higher in younger than in older children.

Advanced Epilepsy Treatment Options Available at World Best Hospital in India

Best Neurosurgery Hospital in India | Neurosurgeon India : Stroke Patient from Nigeria

Till the time a person develops a second seizure, treatment for epilepsy will not begin. This is due to the reason that a person may have one seizure and never develops a second seizure. Medicines are successful in treating epilepsy. These medicines do not cure epilepsy, they prevent recurring of the seizures. These medicines changes the chemical or electrical transmissions in the brain in a particle way that decreases the chance of a seizure.

Vagus Nerve Stimulation (VNS) :

VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one of the nerves on the neck’s left side. This nerve is called as vagus nerve. This device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces the severity and frequency of the seizures. If a person is feeling a warning seizure symptom then extra stimulation is given for preventing recurrence of the seizure.

Ketogenic Diet :  This is also considered as one of the treatment for epilepsy. Ketogenic diet is recommended for children as it involves eating a diet which is low in proteins and carbohydrates and high in fats. The chemical balance of the brain can be altered that also reduces the chance of having seizures. Ketogenic diet is not meant for adults as the diet can result in any other serious medical condition like heart disease, high blood pressure or strokes.

Advanced Surgical Procedures for Management of Epilepsy

Depending on the particular clinical situation, one of the following surgical procedures is chosen by the Medical team at our affiliate hospital. These operations either aim to resect the disease area of the brain, to disconnect it from other areas so as to relieve the seizures, or to lessen their impact.

• Anteromedial Temporal Lobectomy
• Selective Amygdalohippocampectomy
• Electrocorticography guided Resections
• Multiple Subpial transections
• Quadrantic Resections
• Multilobar Resections
• Functional Hemispherotomy
• Vagal Nerve stimulation
• Radiosurgery (selected cases)
  

  Services offered at our Network Hospitals for the treatment of various types of Brain and Neurological Disorders

  • Highly advanced surgeries for the patients with Vascular Malformations, Cerebral Aneurysms, Complex Craniofacial Malignancies andAcoustic Tumours
  • Diagnosis and Treatment of Cancerous Brain Tumours with complete range of treatment options that include surgery, radiosurgery , radiation therapy, chemotherapy and other cancer treatments
  • Deep Brain Stimulation ( DBS) for patients with Parkinson's Disease and tremors from other neurological conditions
  • Paediatric neurologists and neurosurgeons who specialize in the surgical management of a wide range of paediatric diseases including brain tumours, epilepsy, spinal bifida and hydrocephalus
  • Minimally Invasive Brian Surgeriesusing the most sophisticated 3-D image-guided technology
  
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  Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.
  
  
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Causes of Epilepsy in Children : Advanced Surgical Procedures for Management of Epilepsy

To understand epilepsy, you first have to understand how the brain functions. The brain controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that normally communicate with each other through electrical activity.

Epilepsy is defined as two or more seizures that occur without a specific cause. Seizures are altered behavior that occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.

Different kinds of epilepsy are classified according to:

·         Signs and symptoms

·         The child's age when they begin to occur

·         The child’s EEG pattern

·         Neurologic findings on examination

·         Special kinds of imaging (x-ray-type) tests, including magnetic resonance imaging (MRI) and computerized tomography (CT) scans

Seizure Classifications

Focal Seizures

These seizures take place when abnormal electrical brain function occurs in one or more areas of one side of the brain. If the child does not lose consciousness throughout the seizure, the seizure was previously classified as simple. If the child loses consciousness or does not respond appropriately, the seizure was previously classified as complex.

Focal seizures may include one-sided jerking movements of the arms or legs, stiffening, eye deviation to one side or twisting of the body. Sometimes these symptoms follow these other signs:

·         Seeing visions

·         Hearing noises

·         Tasting and smelling things

·         Dizziness

·         A rapid heart rate

·         Dilated pupils

·         Sweating

·         Flushing

·         Stomach fullness

·         Psychic symptoms such as a sense of deja-vu, distortions, illusions and hallucinations

Generalized Seizures

These seizures involve both sides of the brain. As a result, the seizures are less variable than focal seizures.

Typically, they involve brief staring spells; sudden, quick muscle jerks; generalized and rhythmic jerking of the extremities; generalized stiffening episodes; or generalized stiffness followed by rhythmic jerking of the extremities or a sudden loss of muscle tone, resulting in a head drop or sudden fall to the ground.

Causes

Fever (febrile seizures) are caused by fever in children age three months to five years of age, with no other underlying neurologic problems present. Febrile seizures are common and occur in 2-5% of all children. Simple febrile seizures are brief (usually less than five minutes), generalized convulsions that only occur once in the course of an illness.

Metabolic or chemical imbalances in the body may also cause seizures. Conditions that prompt seizures include hypoglycemia (low blood sugar), hypo/hypernatremia (too little or too much sodium in the blood) and hypocalcemia (too little calcium). Meningitis or encephalitis (brain infections) may also induce seizures. Other acute problems that can cause seizures include toxins, trauma and strokes. In children with epilepsy, a common reason for sudden increase in seizures is that the youngsters are not taking their medications as directed.

Trauma at birth or brain abnormalities such as tumors can also be the source of seizures. A lack of adequate oxygen near the time of birth, trauma, infection and stroke can induce a seizure. Sometimes the seizures appear suddenly, although the brain abnormality may have been present for a long time.

Seizures can also develop as a result of a neurodegenerative disease. While neurodegenerative diseases are rare, they can be devastating.

Diagnosis

The best tool the doctor has to evaluate the spells is the child's history. This includes knowing what happened immediately before the seizure, the first indication that something was wrong, a complete description of the event, the level of responsiveness of the child, how long the seizure lasted, how it resolved and what the child did after the event. All or some of the following tests may be used:

·        

Blood tests

·         Electroencephalogram (EEG) – A procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp.

·         MRI – A diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.

·         CT scan – A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices) of the body, both horizontally and vertically. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general x-rays.

·         Lumbar puncture (spinal tap) – A special needle is placed into the lower back into the spinal canal. This is the area around (but not into) the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problem. CSF is the fluid that bathes your child's brain and spinal cord.

Medication

Many types of medications may be used to treat seizures and epilepsy. Epilepsy medications are selected based on:

·         The seizure type

·         Child’s age

·         Side effects

·         Consistent use of the medication

Discuss your child's medication side effects with their physician. While your child is taking medications, different tests may be done to monitor the effectiveness of the medication. These tests may include the following:

·         Blood work: Frequent blood draws testing may be required to check the level of the medication in the body. Based on this level, the physician may increase or decrease the dose of the medication to achieve the desired level. This level is called the "therapeutic level," and is where the medication works most efficiently. Blood work may also be done to monitor the effects of medications on body organs.

·         Urine tests: These tests are performed to see how the child's body is responding to the medication.

·         EEG

You should weigh the risks and benefits of therapy versus the risks of a subsequent seizure before your child begins taking a medicine. Treatment is generally not started after the first seizure in children.

While reports vary, the recurrence risk after the first seizure, if it occurred for no apparent reason, is approximately 40%. The majority of recurrent seizures occur soon after the first event — 50% occur within six months.

The use of only one drug is preferable if possible, as approximately 70% of children become seizure-free on therapy with one medication. Another 15% of children become seizure-free on a combination of several. The final 15% have epilepsy that does not respond to medication.

Other Treatments

·         Ketogenic diet – A strict, high-fat diet useful for generalized seizures that don't respond to medication.

·         Vagal nerve stimulator – A surgically implanted wire around the vagal nerve hooked to a pacemaker device in the chest that is programmed to give intermittent stimulation to the vagal nerve. This device is FDA-approved as adjunctive therapy for partial seizures in children over age 12. However, some researchers believe it’s useful for younger children, as well as in children with intractable generalized seizures.

·         Epilepsy surgery – For some patients, particularly those with focal seizures that don't respond to medication or with identifiable lesions on head imaging studies, epilepsy surgery may be the best treatment.

For more information visit:          http://www.medworldindia.com        
                    https://www.facebook.com/medworld.india

Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

Call Us : +91-9811058159

Mail Us : care@medworldindia.com

Neurosurgery in India's Top Hospitals : Neurosurgery cost in India is amongst the lowest in the world

All the medical operations that deal with the prevention, diagnosis, treatment and rehabilitation of any nervous disorder are termed as neurosurgeries. These include the brain, spinal cord, peripheral nerves and extra-cranial cerebrovascular system. A variety of symptoms such as paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion, etc. may originate as a result of neurological disorders. 

Neurosurgery (or Neurological Surgery) is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system. Neurosurgery is a branch of the surgery discipline which focuses on the brain and spinal cord. It is an extremely advanced form of surgery, requiring many years of training, and a high level of precision and experience on the part of the surgeon.

What are Neurological Disorders?

Amyotrophic Lateral Sclerosis Aphasia Asperger Syndrome Arachnoiditis Dystonia Encephalitis and Meningitis Encephalopathy Facial Nerve Problems Fainting Guillain-Barre Syndrome Head Injury Hematoma Huntington Disease Internal Bleeding Lead Poisoning Learning Disabilities MELAS Syndrome Meralgia Paresthetica Motion Sickness Multiple Sclerosis Myasthenia Gravi

Arteriovenous Malformation Autism Blood Clots Brain Aneurysm Brain Concussion Brain Hemorrhage Brain Tumor Canavan Disease Cauda Equina Syndrome Cerebral Palsy Charcot-Marie-Tooth-Disease Compartment Syndrome Complex Regional Pain Syndrome Creutzfeldt-Jakob Disease Devic's Syndrome Dizziness Pick Disease Pinched Nerve

Stroke Stroke Prevention Thoracic Outlet Syndrome Tourette Syndrome Tremor Trigeminal neuralgia Vertigo Ramsay Hunt Syndrome Restless Leg Syndrome Reye Syndrome Seizure Seizures Symptoms and Types Sinus Headache Spinal Cord Injury Stem Cells Peripheral Neuropathy Neuropathic Pain Parkinson's Disease

What are popular Neurological Procedures?

Craniotomy: A craniotomy is a procedure to remove a lesion in the brain through an opening in the skull (cranium). A craniotomy is a type of brain surgery. It is the most commonly performed surgery for brain tumor removal. It also may be done to remove a blood clot (hematoma), to control hemorrhage from a weak, leaking blood vessel (cerebral aneurysm), to repair arteriovenous malformations (abnormal connections of blood vessels), to drain a brain abscess, to relieve pressure inside the skull, to perform a biopsy, or to inspect the brain. Craniotomy is distinguished from craniotomy (in which the skull flap is not immediately replaced, allowing the brain to swell, thus reducing intracranial pressure) and from trepanation, the creation of a burr hole through the cranium in to the durra mater.

Rhizotomy: Rhizotomy is the cutting of nerve roots as they enter the spinal cord. Rhizotomy (also called dorsal Rhizotomy, selective dorsal Rhizotomy, and selective posterior Rhizotomy) is a treatment for spasticity that is unresponsive to less invasive procedures. Rhizotomy is performed under general anesthesia. The patient lies face down. An incision is made along the lower spine, exposing the sensory nerve roots at the center the spinal cord. Individual nerve rootlets are electrically stimulated. Since these are sensory nerves, they should not stimulate muscle movement. Those that do (and therefore cause spasticity) are cut. Typically, one quarter to one-half of nerve rootlets tested are cut.

Corpus Callosotomy: Corpus Callosotomy is a treatment for epilepsy, in which a group of fibers connecting the two sides of the brain, called the corpus callosum, is cut. It is used to treat epilepsy that is unresponsive to drug treatments. A person with epilepsy may be considered a good candidate for one type of epilepsy surgery or another if he or she has seizures that are not adequately controlled by drug therapy, and has tried at least two (perhaps more, depending on the treatment center's guidelines) different anti-epileptic drugs. The purpose of this treatment is to prevent spreading of seizure activity from one half of the brain to the other. The brain is divided into two halves, or hemispheres, that are connected by a thick bundle of nerve fibers, the corpus callosum. When these fibers are cut, a seizure that begins in one hemisphere is less likely to spread to the other. This can reduce the frequency of seizures significantly.

Stereotactic Radiosurgery: Stereotactic radiosurgery is the use of a precise beam of radiation to destroy tissue in the brain. This procedure is used to treat brain tumors, arteriovenous malformations in the brain and in some cases, benign eye tumors or other disorders within the brain. It works the same as all other forms of radiation treatment. It does not remove the tumor or lesion, but it distorts the DNA of the tumor cells. The cells then lose their ability to reproduce and retain fluids. The tumor reduction occurs at the rate of normal growth for the specific tumor cell. In lesions such as AVMs (a tangle of blood vessels in the brain), radiosurgery causes the blood vessels to thicken and close off. The shrinking of a tumor or closing off of a vessel occurs over a period of time. For benign tumors and vessels, this will usually be 18 months to two years. For malignant or metastatic tumors, results may be seen in a few months, because these cells are very fast-growing.

Meningocele repair: is surgery to repair birth defects of the spine and spinal membranes. Meningocele and myelomeningocele are types of spinal bifida. The surgery is necessary to close this abnormal opening to decrease the risk of infection and protect the integrity of the spina column and the tissue inside. A myelomeningocele is the most severe type of spina bifida because the spinal cord has herniated into the protruding sac. Neural tissue and nerves may be exposed. About 80% of myelomeningoceles occur at the lower back, where the lumbar and sacral regions join. Some people refer to myelomeningocele as spina bifida. Because of the exposed neural tissue, significant symptoms may be present.

·    

Neurosurgery cost in India is amongst the lowest in the world. The cost of neurosurgery in India is just a fraction of the cost in the USA. Neurosurgery cost in India is also significantly cheaper than cost of neurosurgery in comparable hospitals in other popular medical tourism destinations.  The low cost of neurosurgery in India is without any compromise on quality or success rate

World Class Operation Theatres: ADifferentiator at Neurosurgery Hospitals in India

Neurosurgery in India's tophospitals is extremely successful on account of theworld class operation theatres and cutting edge technology that is available to neurosurgeons in India. For example:

• ·         Stereotactic Radiosurgery Suite
• ·         Brain Suite (with Capability for Intra-Operative High-End Magnetic Resonance Imaging)
• ·         Neurosurgery Theatre for Endoscopic Procedures
• ·         X-Knife for Radio Surgeries
• ·         High Accuracy Computer Assisted Neurosurgery with Operation Theatre Linkage to CT Scanner and MRI Machine
• ·         Microsurgical Instruments for Neurosurgeries
• ·         Gamma Knife or Radiosurgery
• ·         Linear Accelerators ( LINACs) / CyberKnife for Radiosurgery
• ·         Neuro-Intervention Laboratory
• ·         Neurosurgerytheatre with Imaging Support for Spine Surgeries

Hospitals Offer RevolutionaryInterventional Neuro Radiology procedures in India:

Treatment of brain and spine disorders are becoming less invasive with the advent of better imaging and interventional technologies. Interventional neuroradiologists in India now offer a wide range of minimally invasive neurosurgeries through angioplasty, placement of stents, treatment of vascular tumors, large aneurysm, embolization for resolution of arteriovenous malformations, etc

What is Cost of Neurosurgery in India?

A huge cost difference is evident in India when it comes to Neurosurgery. India is cheaper along with zero patient wait lists. Interestingly, the quality delivered at such a low cost doesn’t compromise the quality of treatment, as the foreign patients are accustomed to get in their respective country. This is due to the outburst of the private sector which is comprised of hospitals and clinics with the latest technology and best practitioners. The following cost comparison can give a right picture of the claim behind low cost treatment with quality:  

Procedure	USA ($)	UK($)	India ($)
Neurosurgery with Hypothermia	23,000	21,000	6,500
Brain tumor surgery	12,000	10,000	4,500
DBS	28,500	26,000	17,000

For more information visit:          http://www.medworldindia.com      
                    https://www.facebook.com/medworld.india

Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

Call Us : +91-9811058159

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