Epilepsy Talk

Brain Surgery Alternatives | June 7, 2020

“It’s not brain surgery.” And it doesn’t have to be.

There are a host of epilepsy procedures that are minimally invasive.

For example…

The Vagus Nerve Stimulation

(VNS) has been used to treat more than 30,000 epilepsy patients worldwide.

It’s designed to prevent or interrupt seizures or electrical disturbances in the brain for people with hard to control seizures.

Used in conjunction with anti-seizure medications, the VNS uses electrical pulses that are delivered to the vagus nerve in the neck and travel up into the brain.

It’s not clear how this inhibits seizures, but the device can reduce seizures by 20 to 40% and completely control seizures in about 5% of people.

Side-effects of vagus nerve stimulation include hoarseness, throat pain, coughing, shortness of breath, tingling and muscle pain.

Trigeminal Nerve Stimulation

TNS is a new nerve stimulation therapy that requires NO SURGERY and reduces seizures among those who are drug resistant by about 40%.

A recent clinical trial showed that at the end of the 18-week study, 40% of patients receiving TNS experienced a significant improvement in seizure reduction.

The TNS system has two components: a hand-held pulse generator — which is about the size of a cell phone — that creates the electrical signal and a disposable custom electrical patch — much like a gel pad — that delivers the signal to its target, the trigeminal nerve.

Transcranial Magnetic Stimulation

TMS is a noninvasive type of brain stimulation which uses a strong magnet held outside the head to deliver electromagnetic currents to alter the electrical activity in the brain.

This therapy has shown great promise for reducing seizures by reducing neuronal excitability.

Some of the earliest studies found that transcranial magnetic stimulation can induce a prolonged period of protection from the types of electrical activity that cause seizures.

Case studies have found that this technique can reduce seizure frequency by over 60% in some patients.

In addition, researchers found that the TMS treatment also improved the mood of participants. Since depression is a common problem in people with epilepsy, this finding could have significant impact on the quality of life for people who suffer from the disorder.

The most serious side-effect associated with transcranial magnetic stimulation is a headache, though there is a small risk of seizure during this treatment. However, this risk is low and this technique is considered to be safe.

Deep Brain Stimulation

(DBS) may offer a new treatment option for fighting epileptic seizures in those who don’t respond well to other therapies.

Similar to the VNS, it’s minimally invasive and consists of implanting tiny electrodes in the brain that release electrical pulses, reducing the frequency of partial seizures and secondarily generalized seizures.

It also has the ability to constantly analyze brain activity, then deliver the correct electrical stimulation.

Overall, researchers say more than half of those treated experienced a reduction in seizures of at least 50%.

Clinical studies have found that it is generally safe, with the adverse effects being transient and mild.

However, one of the advantages of deep brain stimulation is that it can be switched off — if side-effects appear — and the entire procedure is reversible.

Laser Surgery 

Revolutionary laser surgery — a safer, less invasive alternative to brain surgery as we know it — has slowly been achieving success with brain tumor patients.

Instead of the more traditional craniotomy, in which a bone flap is removed from the skull, neurosurgeons are using MRI-guided laser technology to destroy lesions in hard-to-access regions of the brain.

“This is a tool for patients with tumors who have been told they do not have other options” — Shabbar F. Danish, MD, of Rutgers Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital — says about laser-assisted thermal ablation.

“This is also a viable option for patients who do not want radiation therapy or general anesthesia. Additionally, we can take their hospital stay from four to seven days down to 24 hours.”

The procedure marries the precision of navigation tools…with an MRI-guided laser probe that’s as small and light as a pen.

“What this does is you just have to make a hole that will take you to the middle of the tumor, and (ablate) the tumor.”

It’s actually done in the MRI suite, so when the probe is confirmed to be in the correct position in the MRI suite you heat it and you can watch directly on the MRI scanner what area is being heated using the program.

After that you can do another MRI scan, since the patient is already there, to show if the tumor is gone. So you have instant gratification.”

Gamma Knife Surgery

A number of clinics now offer Gamma Knife Surgery for some kinds of epilepsy, and researchers are working to improve this type of procedure.

Gamma knife surgery, which uses a minimally invasive tool, delivers radiation treatment as though it were an actual knife, offering the kind of precision and targeting as surgery.

These finely focused radiation beams intersect at a specific region of the brain to alter the cells in that region.

In many cases, this can stop the abnormal electrical activity that causes the seizures.

A study of gamma knife surgery in patients with temporal lobe epilepsy, found that 67% of the treated patients were seizure-free 2 years after surgery.

Another study published looked at the use of gamma knife surgery to perform callosotomy in patients with severe generalized epilepsy with drop attacks.

The results were comparable to a traditional callosotomy, in which a band of nerve fibers connecting the two halves (hemispheres) of the brain are cut, disabling communication between the hemispheres and preventing the spread of seizures from one side of the brain to the other.

(This procedure, sometimes called split-brain surgery, is for patients with extreme forms of uncontrollable epilepsy who have intense seizures that can lead to violent falls and potentially serious injury.)

Researchers are continuing to test gamma knife surgery to learn what types of epilepsy can be effectively treated, what radiation frequencies are best, what type of pre-surgical testing is necessary, and what benefits and side-effects are possible with this type of surgery.

Biofeedback

Since the 1970′s, researchers have demonstrated in over 50 controlled studies that a special form of brain wave biofeedback — now called “neurofeedback” — safely and effectively “retrains” the brain to stabilize its activity.

The treatment has been used successfully with all types of seizure disorders. Often the effects are permanent.

The procedure begins by attaching EEG electrodes to the body to gauge brain wave activity. And the learning takes place by practicing computer “game” challenges while receiving positive reinforcement from the computer.

One of the most beneficial aspects of biofeedback is the reduction of stress in everyday life, which in turn, also helps reduce seizures.

According to research, approximately 50% seizure control is attained within approximately 2-3 months and full seizure control can occur somewhere between 6-18 months.

However, the drawback is that biofeedback is not covered by health insurance, requires many treatments, and is expensive.

Cell Transplantation

Another emerging approach for treating epilepsy is cell transplantation.

Researchers can transplant either mature cells or stem cells derived from fetal tissue.

Cells used for transplant are sometimes genetically engineered to produce substances to reduce seizures or protect neurons from damage.

Cell transplantation therapies for epilepsy are still in preliminary stages of development.

However, the encouraging results of animal studies suggest that this type of therapy may eventually be used to treat drug-resistant epilepsy in humans.

One study tested whether transplanting GABA producing cells into the brains of rats could suppress seizures. (GABA cells are neurotransmitters that slow down the activity of nerve cells in the brain.)

The cells raised GABA levels in the brain tissue, raised the seizure threshold, shortened the duration of brain discharges after seizures, and slowed the development of seizures.

Another study tested the effect of neural stem cell transplantation in rats with status epilepticus induced by a toxin.

The neural stem cells inhibited and decreased neuron excitability.

Yet another study found that grafting specific types of fetal hippocampal cells into the brains of adult rats with toxin-induced brain lesions, reduced the amount of abnormal nerve fiber growth in the brain.

The grafted cells also developed connections with other regions of the brain, suggesting that they may be able to form functional brain circuits.

Gene Therapy

The discovery of gene mutations that cause specific epilepsy syndromes has led to the possibility of using gene therapy to counter the effects of these mutations.

In gene therapy, researchers typically use viral vectors — transmitting modified genetic material — to introduce new genes into brain cells.

Viruses can also be used to introduce genes for proteins such as GABA into non-neuronal cells.

These cells are then transplanted into the brain to act as “factories” to produce potentially therapeutic proteins.

One advantage of gene therapy is that it can alter the cells in just one part of the brain.

Researchers can control the activity of the introduced genes by using a genetic “switch” that responds to antibiotics or other chemicals.

This allows doctors to turn the gene therapy off if it causes intolerable side-effects or other problems.

Theoretically, this type of therapy should last longer and cause fewer side-effects than medication.

Hormone Imbalances

Females who have epilepsy often have increased severity of their seizures at specific points during their menstrual cycle — known as catamenial epilepsy — when progesterone levels are low.

Research has found that estrogen increases neuronal excitability and progesterone reduces neuronal activity, which suggests that an imbalance between estrogen and progesterone could increase seizure frequency.

Lower progesterone levels are also associated with more frequent seizures in women, and elevated estrogen levels during perimenopause also appear to increase the possibility of seizures.

Progesterone restoration therapy has been studied as a possible treatment for epilepsy and initial results have been promising.

The effects of hormones on epilepsy still needs to be better defined since some studies have suggested that estrogen can have pro-epileptic and anti-epileptic results, depending on the levels.

Also, women are not the only patients that can have their epilepsy affected by sex hormone levels. Testosterone and its metabolites also have anti-seizure effects.

In a case report of a man with post traumatic seizures, testosterone therapy caused his seizures to lessen and nearly disappear.

These findings suggest that maintaining optimal testosterone levels may lessen seizure disorders in men. (Free testosterone is a good indicator of testosterone activity; optimal levels are 20 – 25 pg/mL.)

Naturopathy

Naturopathic medicine treats the whole person, taking into account the interaction of physical, mental, and emotional factors as causes of a condition.

It seeks to recognize the importance of the whole person instead of just single organ systems or particular symptoms.

When it comes to epilepsy, naturopathy and a range of related treatment methods may have a good deal to offer, as long as it is coordinated with your neurological care.

Options include: aromatherapy, acupuncture, behavior control, massage, yoga, meditation, stress management and vitamins, to name just a few.

Homeopathy

The main argument for treating epilepsy — or any disease — with homeopathy is the concept that each patient is different.

Though they may be diagnosed with the same disease or disorder, their symptoms are different, as are their responses to treatment and medication.

This is why people believe there are many benefits to treating epilepsy based on symptoms rather than the generalized disease.

By being able to zero in on exact symptoms which patients are experiencing, it’s believed that homeopathy will have a better chance of treating those specific symptoms.

Alone, homeopathy may not help all cases of epilepsy.

But together with conventional treatment, it’s seen success as a supportive line of treatment.

And in cases of drug-resistant epilepsy, people often do respond significantly to homeopathy.

Counseling

Therapy can go a long way towards reducing the fear, anxiety, depression, and isolation of epilepsy.

Sure, your epilepsy isn’t going to disappear. But learning to accept it, live with it and become a survivor rather than a victim, can go a long way to a happy and productive life.

I had epilepsy for 20+ years. And I know for a fact, that therapy has been a life-saver for me.

But ultimately, like everything else, your choice of treatment is just that. A decision you make that’s hopefully well-informed and best suits your particular circumstances.

No one can tell you what to do, or which course is best. It’s your choice.

But it’s always good to know you have options.

And if you have a particular treatment that has worked especially well for you — please sing out and let us know!

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Resources:

http://www.medicinenet.com/vagus_nerve_stimulation_vns/article.htm

http://www.wisegeek.com/contest/what-is-vagus-nerve-stimulation-or-vns.htm

http://www.npr.org/2011/07/27/138619259/new-device-reduces-seizures-no-surgery-required?ft=1&f=100

http://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/home/ovc-20163795

http://www.webmd.com/epilepsy/news/20100317/deep-brain-stimulation-stops-seizures

https://www.disabled-world.com/health/neurology/epilepsy/laser-surgery.php

https://www.sciencedaily.com/releases/2014/06/140602132115.htm

http://www.newswise.com/articles/gamma-knife-surgery-benefits-epilepsy-patients-beyond-seizure-reduction

http://epilepsyinanutshell.blogspot.com/2008/02/gamma-knife.html

http://www.epilepsyhealth.com/biofeedback.html

http://www.ucsf.edu/news/2008/08/7716/cell-transplantation-holds-promise-epilepsy1

https://www.sciencedaily.com/releases/2010/08/100825093541.htm

http://www.sciencedaily.com/releases/2013/12/131208090333.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fhealth_medicine%2Fepilepsy+

http://www.medicalnewstoday.com/releases/268307.php

 


18 Comments »

  1. I have just started an epilepsy & Cerbral Palsy site may I share this post on there. I will weblog it back to you if you want

    Liked by 1 person

    Comment by Kenneth Ratcliffe — June 7, 2020 @ 11:18 AM

    • Feel free to as long as you attribute the source. These articles are meant to inform and share. The more, the better!

      Like

      Comment by Phylis Feiner Johnson — June 7, 2020 @ 1:16 PM

  2. Great info. Maybe we could learn about ultrasound therapy, which is being studied right now with optimistic results so far?
    https://www.fusfoundation.org/the-foundation/news-media/first-patient-treated-in-epilepsy-clinical-trial

    Liked by 2 people

    Comment by abilene220 — June 7, 2020 @ 11:53 AM

  3. Reblogged this on Ken's Devotions.

    Like

    Comment by Kenneth Ratcliffe — June 7, 2020 @ 1:43 PM

  4. laser ablation surgery is also good for brain injury sites. the laser ablates the dead tissue causing the seizures. I was a candidate for this. so far so good. hoping it stays that way.

    Liked by 2 people

    Comment by Laura Little — June 7, 2020 @ 3:06 PM

  5. LIFE IS NOT MEANT TO BE EASY. WHY DO WE HAVE TO SUFFER SO MUCH?
    I HAVE HAD TEMPORAL LOBE SURGERY, THAN AFTER A FEW MONTHS HAD TROUBLE WITH MY BALANCE WHEN WALKING AND HAD DIFFICULTY IN MOVING MY LEGS. THEY FOUND BLOOD IN THE HEAD PUTTING PRESSURE ON THE BRAIN AND TOO MUCH FLUID IN THE HEAD.
    I HAD ANOTHER SURGERY TO CLEAN EVERYTHING UP. HAS THIS HAPPEN TO ANYONE ELSE? THIS SURGERY IS CALLED BURR HOLE SURGERY.
    THE FOLLOWING YEAR THEY PUT A SHUNT IN THE HEAD FOR THE EXCESS FLUID.
    AFTER AROUND 16 MONTHS THE PAIN IN MY LEGS RETURNED AND MY BALANCE WAS A PROBLEM. THE DOCTORS FOUND OUT THAT MY SHUNT WAS BLOCKED AND IT HAD TO BE REPLACED. OF TO ANOTHER SURGERY FOR THAT.

    THE EPILEPSY HAS IMPROVED, WE HAVE CUT BACK ON A FEW MEDICATIONS, WHICH IS GREAT.

    BUT ONLY ONE PROBLEM I HAVE HAD ALL THESE OTHER THINGS GO WRONG WITH ME, AS I SUFFER STILL TODAY WITH HEADACHES EVERYDAY AND PAIN ON THE LEGS.
    I DO NOT KNOW WHAT TO DO ANY MORE?
    HAS ANY ONE ELSE EVER HAD A SHUNT PUT IN THERE HEAD?

    i FILL LIKE I AM BETTER OFF JUST GIVING UP, I HAVE HAD ENOUGH OF LIFE.

    i AM BETTER OFF DEAD, WHATS THE USE OF LIVING, NOTHING GOES RIGHT, EVERY DAY i WAKE UP WITH HEADACHES.
    THE GP JUST PUT ME ON MEDICAL CANNIBALS FOR THE HEADACHES. ANYONE TRIED THIS?

    ONE MORE THING JUST 2 WEEKS AGO THEY DID A MRI OF MY BACK AND FOUND MINOR DISC BULGE AND A ANNULAR TEAR. THIS WAS DONE AS WHEN I WALK IT FEELS DIFFERENT, THE PAIN IN MY LEGS.

    I HAVE PROBLEMS WITH MY BRAIN AND NOW PROBLEMS WITH MY BACK, SO I REALLY BETTER OFF DEAD.
    GOODBYE

    Liked by 1 person

    Comment by SAM — June 8, 2020 @ 6:10 AM

    • Oh Sam, what a horrid ordeal you’ve been through. And after all the failed attempts at normalcy, I could see how you’d want to give up.

      But don’t go there. I’ve already tired.

      The result was two heart attacks, an induced coma for 5 days, the psych ward for another 5 days and then 5 more days of outpatient.

      It’s not a pretty place.

      There are people who love and care for you. To them it would be a punishment.

      Think of them and don’t leave them behind.

      Like

      Comment by Phylis Feiner Johnson — June 8, 2020 @ 10:48 AM

    • Yes Sam I have tingly numbness almost crawly up my legs and the back of my neck too!! It mostly started REALLY BAD IN EARLY 2018. I have had maybe 3-4 concussions but and major concussion back in 2015 when I had a seizure and fell down my cement front door steps. I agree the pain in the neck that leads to the CONSTANT PAIN IN THE HEAD IS THE WORST!!!!!!! Mostly because (unless a C.T.Scan or MRI or EEG is performed NOBODY WILL BELIEVE YOU)!! I have RIGHT TEMPORAL LOBE EPILEPSY as well and apparently the right side of my brain is actually smaller than the left side, but works TWICE AS HARD FOR BOTH SIDES!!!!! I was actually offered surgery back in 2010 but my children were all WAY TOO YOUNG!! And I didn’t want to even consider it until they were at least all graduated HighSchool. This year they will all be graduated and I wouldn’t have changed anything for the world (except the neck pains, numbness, tingling, and NASTY NASTY HEADACHES!!). I was also told I had fluid in my brain because of the concussions and STILL have to have an “ELECTROLYTE POWER” in my drink everyday and only drink 10-8 ounce cups of fluid a day which includes soups. I haven’t had a shunt put in though so I apologize I can’t speak to that, but PLEASE KNOW YOUR NOT ALONE AND PLEASE TRY AND BE A POSITIVE ROLE MODEL for those younger epileptics who already feel the way you do and FOR YOURSELF!!!!! Please be well and TAKE CARE OF YOURSELF AND PRAY (however that maybe). 🙏🏼🙏🏼🦅🦅🦅🦅🦅💕💕💕💕💕🙏🏼

      Liked by 1 person

      Comment by Kathy S.B — June 9, 2020 @ 10:09 AM

  6. […] Brain Surgery Alternatives — Epilepsy Talk […]

    Like

    Pingback by Brain Surgery Alternatives — Epilepsy Talk – Epilepsy & Cerebral Palsy — June 8, 2020 @ 12:00 PM

  7. We did neuro biofeedback for my son and I like to think it helped but it was $500 for the first brain map and then $75 for each session and then another $500 for the comparison brain map.We did it for about 4 months. It was just too expensive. It would be very helpful to the E community if this was covered by insurance. It is covered if they were in an auto accident and suffered a TBI but not for E.

    Liked by 1 person

    Comment by Tami — June 8, 2020 @ 8:57 PM

    • That’s kind of unfair. One is for an accident but not for naturally occurring epilepsy. What is it then? Mere folly?

      Like

      Comment by Phylis Feiner Johnson — June 8, 2020 @ 9:06 PM

  8. You always provide such excellent info! I swore for a long time that I wouldn’t have brain surgery for my epilepsy, but when I heard about the laser ablation I was intrigued. I had the procedure 2 years ago and it ended my seizures!

    Like

    Comment by Suzanna Price — June 9, 2020 @ 10:49 AM

  9. YAY for you Suzanna! I always love to hear good news. And since today is my birthday, it’s a gift to me that you’re now free of seizures!

    Like

    Comment by Phylis Feiner Johnson — June 9, 2020 @ 10:52 AM

  10. Ok, Hormones 101, adapted from the book, Hormones: A Very Short Introduction, by Martin Luck.

    (I have no medical training.)

    Your body needs to have internal events happen at a given time and in a specified sequence. The two systems that control your internal physical events are the nervous system and the hormone (endocrine) system.

    A hormone is a chemical signal that may come from a gland or from some other organ that can influence what happens nearby or far away. Distance is not a problem if blood or other fluid acts as a carrier.

    Hormones include many that are not sex-related. There’s melatonin, there are the thyroid hormones, and many more.

    For a hormone to be effective, it must be met by an appropriate receptor.

    All of these processes are time-dependent. They are influenced by what happens in the outside world as well as internally. Everything must be in good working order.

    The brain produces its own hormones, which influence bodily processes, just as bodily hormones influence the brain. It’s four-dimensional (including time as a dimension) and complex enough to not be fully understood.

    Now – this is me, not the author – add meds, which can influence your hormones, your brain, your body, how things happen in time. It’s like adding a fifth dimension. You can probably see, now, how very complicated it can be, and how an endocrinologist, or a neuro-endocrinologist, might be a good addition to your team.

    Hope this helps some.

    Liked by 1 person

    Comment by HoDo — June 19, 2020 @ 12:08 PM

  11. Hodo, thanks for the info about hormones. It is a delicate and complicated system. To me, taking seizure meds is like dropping tiny bombs on that delicate system. And what did Endocrinologists suggest? Other meds, lol.

    Liked by 1 person

    Comment by skolly9 — June 19, 2020 @ 2:19 PM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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