A 34-year-old man, who suffered from epilepsy, underwent a non-invasive procedure - Cyberknife Radiosurgery - at Apollo Cancer Centre early this year.
The patient, an athlete and software professional from New Zealand, suffered from Medial Temporal Lobe Epilepsy (MTLE). He started to experience occasional attacks of unconsciousness in 2009. He was diagnosed with simple partial seizures and was under treatment in New Zealand. But, he went on to suffer multiple seizure attacks and imaging revealed MTLE, a rare type of epilepsy. As the seizures increased in frequency and could not be controlled with medications, he was advised to explore a surgical option.
On consulting with Shankar Vangipuram, senior radiation oncologist and Cyberknife expert, Apollo Cancer Centre, he underwent a neuropsychological assessment which showed that he had visual memory scores at the 90th percentile.
S. Muthukani, senior epileptologist, Apollo Hospitals, said that MTLE affected the inner part of the temporal lobe of the brain, in an area called hippocampus that processes memories. “Nearly 30% of patients with epilepsy are resistant to medications. This is called refractory epilepsy in which two properly chosen anti-epileptic drugs do not work in patients,” he told reporters on Thursday. “In surgery, resecting the area of the hippocampus can significantly impair memory -- visual or verbal memory depending on the side,” he added.
This was where Cyberknife Radiosurgery came in. “We recommend non-invasive procedures when our goal is to preserve memory. It is a daycare procedure and is done in 30 to 40 minutes. However, this is not for all patients. There are specific indications such as young patients with high neuropsychological scores,” Dr. Vangipuram explained.
The procedure involves delivery of X-ray/gamma rays with accuracy. “We localise the area that needs to be treated. We use multiple tools such as high resolution MR scan and PET CT, and plan the treatment as it is close to critical parts of the brain such as the visual apparatus and brain stem,” he added.
The patient said that after treatment, the frequency and magnitude of episodes have reduced quite a lot. “I had several major episodes in which I have fallen on the road and collapsed in the gym. It affected my attention span and memory,” the patient said.
Doctors said his major seizures were now under control and he continues to be on lower doses of medications.
