SANTA CRUZ DE TENERIFE, 19th June (EUROPA PRESS) –
The Epilepsy Unit of the Canary Islands University Hospital Complex (HUC) has recently been appointed as a key unit for epilepsy surgery in the Canary Islands. It is a diverse unit consisting of neurologists, neurosurgeons, neurophysiologists, and nurses. It features a dedicated consultation room and the video-EEG monitoring Unit, equipped with a 128-channel electroencephalography device that allows continuous video recording. This facilitates the recording of both the patient’s clinical symptoms and electroencephalographic activity over a variable period, depending on the indication required.
This morning, the announcement was made by the manager, Adasat Goya, along with the head of Neurosurgery, Héctor Roldán, neurosurgeon Liberto Brage, neurologist Dionisio García, neurophysiologist Pedro Pérez Lorensu, and Nursing supervisor Manuel Rosa, during a press conference.
Epilepsy surgery is focused on locating and isolating the epileptic focus or preventing the spread of abnormal discharge to regions with more significant clinical consequences. It aims to either cure epilepsy, eliminate seizures, and potentially discontinue antiepileptic medication if the patient’s progress is positive. Although in some cases it can cure epilepsy, in most instances, it assists in better control of epilepsy by reducing seizure frequency or severity.
In addition to resective epilepsy surgery, this Unit also undertakes surgeries for the implantation of vagus nerve stimulators. This device, usually implanted in the left hemithorax similar to a pacemaker, delivers a semi-continuous electrical stimulus through an electrode connected to the vagus nerve towards the thalamus through the ascending reticular structure.
Vagus nerve stimulation is a palliative technique that is not curative for patients with drug-resistant epilepsies, particularly those with structural lesions that are not suitable for curative resective surgery. It is notably beneficial for certain patients.
The HUC Epilepsy Unit can conduct continuous monitoring for two patients simultaneously, seven days a week. This monitoring aids in recording the seizures experienced by the patient, enabling a more accurate diagnosis of the episodes presented. It is crucial in determining the type of seizures and epilepsy a patient is dealing with. Up to 20-30% of patients referred to a specialist centre for refractory epilepsy do not actually have epilepsy and are suffering from another type of condition.
Monitoring is particularly valuable in cases where the seizure type and epilepsy diagnosis are uncertain, especially when the response to treatment is inadequate. It also helps in identifying seizure-triggering factors in specific patients, such as photostimulation, sleep deprivation, and reflex epilepsies.
Clinical interviews may not always accurately evaluate seizure frequency in certain patients, such as those with absence seizures, epilepsy coupled with severe intellectual disabilities, or those living independently. Recording and quantifying seizures provide a realistic assessment of the situation.
In 2023, video-EEG monitoring was conducted on 67 patients, revealing that fourteen had non-epileptic seizures and seventeen had epileptic seizures, with twelve being minors, including patients from other islands.
EPILEPSY
Epilepsy is a persistent medical condition with neurobiological, cognitive, psychological, and social repercussions that necessitate long-term monitoring by a neurologist. The goal is to achieve better seizure control and improve the patient’s overall condition through optimal antiepileptic therapy.
According to the EPIBERIA study conducted by the Spanish Society of Neurology on epilepsy prevalence in Spain, an estimated 578,000 individuals in Spain will experience epilepsy at some point in their lives, with 225,000 having had epileptic seizures in the past 5 years. Annually, between 12,400 and 22,000 new cases are identified.
Epilepsy can be challenging to diagnose and there may be delays depending on disease progression. Approximately 25% of seizures go unnoticed by patients and their families, and diagnostic errors are found in roughly 20% of uncontrolled seizure cases.
Epilepsy, particularly in drug-resistant cases, poses significant socio-health challenges. The average annual cost of resources utilised by drug-resistant epilepsy patients in Spain is approximately €7,000, with over 26,000 working-age individuals in Spain having disabilities related to epilepsy.
Despite epilepsy being a chronic condition, there are highly effective treatments available to reduce or halt seizures. Presently, around 75% of epilepsy patients can control their seizures with existing medications. However, approximately 30% have drug-resistant epilepsy and may require alternative therapies, including surgery or palliative procedures like vagus nerve stimulation with subcutaneous implant devices.
