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Following the sudden and tragic death at the age of 30, of Omer Datz, son of Moshe and Orna Datz, from an event that the doctors estimate is related to epilepsy - Rambam experts explain the disease, the treatments, and the possibility of living a completely normal life with it.

What is epilepsy?

Epilepsy is a neurological disorder that manifests itself in repeated convulsions that originate from a "malfunction" in the abnormal electrical activity in the brain. The convulsions vary from patient to patient, and their classification depends on their location and intensity. About 84 thousand epilepsy patients live in Israel.

Epileptic seizures are caused by various reasons, among them - brain events, birth defects or genetics, tumors, injuries, infections and more. Sometimes they may occur following a certain stimulus that triggers the attack in some patients.

Rambam experts explain how it works ► Watch

How is the disease diagnosed?

The appearance of only one seizure does not necessarily indicate epilepsy. In order to diagnose the disease, additional seizures must occur. In patients who suffer from repeated convulsive episodes, an EEG test is usually performed, which monitors the brain activity in a non-invasive manner, and makes it possible to diagnose and classify the epileptic disorder. In more complex cases, additional imaging tests such as brain MRI or brain CT can be performed to locate the epileptic focus, and other reasons for the onset of the disease.

Is there a treatment for the disease and is it effective?

For the disease, which affects about 1 percent of the population, there are effective and good drug treatments that help most patients live a normal and normative life with the disease in a balanced way. However, a third of the patients develop resistance to the drug treatment, and although they receive maximum drug support, they still continue to suffer from convulsive attacks.

For some of these patients, there is a surgical option that can provide the answer that the drugs fail to provide. The surgical options are divided into two types:

  • One - cases where the epileptic focus is located and then it can be neutralized by burning or removing it, without damaging functional areas.
  • The second - cases where it is not clear what the epileptic focus is, or it is not possible to reach it. Then it is possible to perform various surgical procedures aimed at mitigating the scope and intensity of epileptic seizures.

These surgeries are performed on patients aged zero to 99, by multidisciplinary teams that include neurosurgeons and neurologists specializing in the treatment of epilepsy.

How is the surgical procedure performed for targeted treatment of epilepsy?

Dr. Muni Benifala, The director of the children's neurosurgery unit and an epilepsy surgeon at MBM, explains: "The procedure is divided into two: in the first stage, an investigation is carried out with the aim of locating the focal point in the brain that causes epilepsy, while marking its border with functional areas of the brain. After that, the medical teams work with different methods to "turn off" the same area.  

The diagnostic phase takes place within the Rambam multidisciplinary center for the treatment of epilepsy, in which an accurate diagnosis of the type of epilepsy in the various patients is carried out in the designated patient population. This diagnosis allows the team of experts to adjust the treatment that may help each and every patient.  

Most inquiries regarding the location of the area that causes epilepsy (eliptogenic source) are done by non-invasive means, but sometimes this inquiry does not yield an accurate picture, and these patients are offered an advanced inquiry to locate that diseased area through deep brain mapping.

In this diagnostic procedure, electrodes with a minimal diameter are inserted into the brain tissue, where sometimes the test will include up to 100 electrodes. This is a minimalist surgery, like which dozens of cases are performed every year. The procedure does not harm the functions of the brain and, in more complex cases, makes the monitoring and locating the problematic focus that requires treatment more precise.

The electrodes remain for several days, during which, while the patients remain hospitalized, the seizures are monitored in an amount sufficient to collect the information necessary for the success of the procedure. This is a complex process that is navigated by Rambam Prof. Yitzhak Shiler and Dr. Moshe Hershkowitz, neurologists with special expertise in epilepsy, who are entrusted with mapping the area.

About a month after the mapping phase, the second part of the procedure is carried out - the treatment phase of the elliptic zone, based on the information produced by the neurologists. In the second part of the treatment, the neurosurgeons perform a minimally invasive surgery aimed at neutralizing the marked area by burning or excision of the process.'

Does this treatment really help epilepsy patients who develop drug resistance?

The goal is to cure the epilepsy without damaging functional areas, and to return the patients to leading a normal life. According to the data, we are talking about success in 70% of cases, and a significant decrease in the frequency of attacks among 20% ​​of patients. The surgeries are performed on patients without age restrictions, provided they suffer from focal epilepsy that is suitable for this treatment. The change is immediate. This is a tool that definitely changed the face of the field in terms of treatments.

Can epilepsy be fatal?

Dr. Veronika Chernoha, senior neurologist at Rambam and head of the drug-resistant epilepsy clinic for children: "Death among epilepsy patients is a relatively rare condition, especially among adults, with a frequency of about 1.6 per 1,000 epilepsy patients.

About 30% of the population of epilepsy patients are resistant to drug treatment, while some of them will be referred to surgery as a means of treatment. Living with epilepsy in an unbalanced state that may lead, in some cases, to incessant convulsions (status epilepticus) despite drug treatment, or to a condition called sudden death in the professional jargon - sudden death for an unknown reason, when in some cases there was evidence of convulsions during sleep.

The common causes of Sudep are: long-term illness, failure to take anticonvulsant medications, excessive fatigue, drinking alcohol."

Rambam experts in surgery (photo: Rambam)
Rambam experts in surgery (photo: Rambam)

Contact Chai here: At watsapBy email

Rambam Medical College for Human Health
Rambam Medical College for Human Health
Rambam Medical College for Human Health - The vision: to lead medicine in Israel and make a mark in Israel and the world in treatment, innovation, research, technology and the development of the professional staff, while placing the person, the patient and the employee, at the heart of the action. Inquiries and questions: [email protected]

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