Published on July 6th, 20180
Epilepsy Surgery at St. Luke’s Eliminates Seizures
June 26, 2018 – St. Luke’s University Health Network is the first in the greater Lehigh Valley to perform a revolutionary epilepsy surgery that eliminates seizures in most patients.
“For patients with intractable epilepsy, epilepsy surgery should be considered,” explains Scott Kohler, MD, epileptologist, St. Luke’s Neurology Associates. “The decision for surgery isn’t taken lightly, but for some patients, surgery gives them the highest likelihood of becoming seizure-free.”
Previously, patients with a common type of epilepsy, temporal lobe epilepsy, could only find the treatment, known as temporal lobectomy, at large institutions outside the region.
Dr. Kohler is one of four epileptologists at St. Luke’s Epilepsy Center who identify potential candidates for the surgery. To be considered for surgery like a temporal lobectomy, patients must be medically refractory, which means they have tried at least two medications and sometimes different types of implantable devices yet continue to have seizures.
Research has demonstrated that if patients don’t respond to a second medication to treat their epilepsy, their chance of obtaining seizure freedom is less than four percent, leaving them little to no alternatives to treat their condition. But surgery like a temporal lobectomy can carry an up to 70 percent cure rate, so it is sometimes the patient’s best option.
“Before surgery is even suggested, patients undergo evaluation and testing including EEGs, MRI, PET scans and neuropsychological testing, to identify the hot spot in the brain that causes seizures,” says Dr. Kohler. Then, his team, including epileptologists, a neuroradiologist, neurosurgeon and neuropsychologist, review and discuss all relevant information before making the recommendation to proceed with surgery.
Functional neurosurgeon, Steven Falowski, MD, St. Luke’s Neurosurgical Associates, performs the temporal lobectomy. “During the temporal lobectomy, we remove the abnormal tissue that is not functioning properly,” explains Dr. Falowski. “Initially, this sounds like a scary prospect to patients, but you have to remember that the tissue being removed is abnormal and causing the seizures so it does not belong there.”
Typical outcomes for epilepsy surgery are measured at one and two-year markers, so they continually monitor patients post-surgery, even if they become seizure free. “Our most recent temporal lobectomy patient was a textbook candidate for the procedure,” says Dr. Falowski. “She did wonderful and was discharged home as expected after a few days in the hospital. The day before the surgery, she had five seizures, and has had none following the procedure.”
Temporal lobectomy is one of many treatments offered by the comprehensive epilepsy program at St. Luke’s, comprised of an expert team of epileptologists, neurologists, functional neurosurgeon, neuropsychologists, neuroradiologists, an epilepsy nurse navigator, social workers, registered EEG technologists and specially trained nurses who all specialize in the treatment of patients with epilepsy and seizures.
“Our whole team is always cognizant of the fact that we are aiming to restore quality of life for these patients,” says Dr. Falowski. “It is very difficult to function in society if you are even having one seizure per month – you are not allowed to drive and working can be very difficult as your job choices become limited. Our goal with the St. Luke’s Epilepsy Center is seizure freedom to restore quality of life.”
St. Luke’s Epilepsy Center is accredited as a Level 3 Epilepsy Center by the National Association of Epilepsy Centers (NAEC). According to the NAEC, Level 3 Epilepsy Centers “have the professional expertise and facilities to provide the highest level of medical evaluation and treatment for patients with complex epilepsy.”