Why in News:-
- Recently Oran Knowlson, a teenager living in the UK, became the first person in the world to get a brain implant to control his epileptic seizures.
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UPSC Syllabus : Prelims: Current events of national and international importance Mains: GS-III: Science and Technology- developments and their applications. |
What is epilepsy?
- Epilepsy is a neurological disorder in which abnormal electrical activity in the brain causes recurrent seizures.
- Affects about 50 million people worldwide.
- In India, 3 to 11.9 out of every 1,000 people suffer from epilepsy.
Types of seizures:-
- Focal seizures: Originate in one area of the brain.
- Simple focal seizures: Affect a small part of the brain, causing minor symptoms.
- Complex focal seizures: Cause confusion and affect consciousness.
- Generalized seizures: Involve all areas of the brain.
- Absence seizures: Brief loss of consciousness.
- Tonic-clonic seizures: Involve convulsions and loss of consciousness.
Causes:-
- Genetic factors: Hereditary conditions or mutations.
- Brain injuries: Trauma, stroke, or tumors.
- Infections: Meningitis or encephalitis.
- Developmental disorders: Autism or neurofibromatosis.
Symptoms:-
- Seizures: Vary in intensity and duration.
- Physical symptoms: Muscle jerks, stiffness, loss of consciousness.
- Psychological symptoms: Anxiety, fear, or déjà vu.
Diagnosis:-
- Neurological exam: Assess motor abilities and behavior.
- Electroencephalogram (EEG): Detects abnormal brain activity.
- Imaging tests: MRI or CT scan to identify brain abnormalities.
- Blood tests: To detect underlying conditions.
Treatment:-
- Medications: Anti-epileptic drugs (AEDs) to control seizures.
- Surgery: Removal of the area of the brain that causes seizures.
- Treatment: Vagus nerve stimulation or ketogenic diet.
- Lifestyle changes: Adequate sleep, stress management, avoiding seizure triggers.
Corpus callosotomy
- Corpus callosotomy is a surgical procedure that involves cutting the corpus callosum, the band of nerve fibers that connects the two hemispheres of the brain.
- This procedure is mainly performed to treat severe epilepsy.
- By severing the corpus callosum, the spread of epileptic seizures from one hemisphere to the other is reduced, which can help control the frequency and intensity of seizures.
Procedure:-
- Pre-surgical evaluation: Patients undergo extensive pre-surgical evaluation, including MRI scans, EEG monitoring, and neuropsychological assessments.
- Surgery: Surgery is performed under general anesthesia.
- The surgeon makes an incision in the skull and removes a small portion of the skull to access the brain.
- Using advanced imaging techniques, the surgeon then carefully cuts the corpus callosum, partially or completely, depending on the patient's specific situation.
- Post-surgery care: After surgery, patients are monitored in the hospital for several days. Follow-up care includes regular checkups, MRI scans, and adjustments to any ongoing epilepsy medication.
Outcomes and risks:-
- Benefits: Corpus callosotomy can substantially reduce the frequency and severity of seizures in patients with intractable epilepsy. It is particularly effective for atonic seizures (drop attacks) and generalized tonic-clonic seizures.
- Risks: Like any major surgery, corpus callosotomy carries risks, including infection, bleeding, and adverse reactions to anesthesia.
- Possible side effects may include speech and language difficulties, memory problems, and changes in cognitive function.
What other treatments are available for epilepsy?
- Treatment for epilepsy aims to control seizures with the least possible side effects.
Available treatments include:
- Ketogenic diet: A high-fat, low-carbohydrate diet that has been shown to reduce seizures, particularly in children with treatment-resistant epilepsy.
- Vagus nerve stimulation (VNS): A device implanted under the skin that stimulates the vagus nerve to reduce the frequency of seizures.
- Responsive neurostimulation (RNS): A device implanted in the brain that detects abnormal electrical activity and delivers electrical stimulation to stop seizures.
- Surgery: Surgically removing the brain area that causes seizures may be an option when seizures are limited to one area.
- Corpus callosotomy: A surgical procedure that cuts the corpus callosum to prevent the spread of seizures between the brain hemispheres.
What is a deep brain stimulation (DBS) device and what are its uses?
Deep brain stimulation (DBS) device
- A DBS device is a medical device implanted in the brain to deliver electrical impulses to specific areas.
- It consists of electrodes placed in targeted brain areas and a pulse generator implanted in the chest.
- The device sends continuous electrical signals to the brain, which help regulate abnormal brain activity.
Uses of DBS Device :-
- Epilepsy: DBS can help reduce the frequency and severity of seizures in patients with epilepsy who do not respond to medication.
- Parkinson's disease: DBS is commonly used to treat movement disorders associated with Parkinson's, such as tremors, rigidity, and bradykinesia.
- Essential tremor: DBS can help manage severe tremors that interfere with daily activities.
- Dystonia: Movement disorders that cause muscle contractions and abnormal postures can be treated with DBS.
- Obsessive-compulsive disorder (OCD): In some cases, DBS is used to manage severe, treatment-resistant OCD.
How DBS works:-
- Pre-surgical evaluation: Patients undergo a thorough evaluation, including brain imaging and neuropsychological testing, to determine suitability for DBS.
- Surgery: Surgery is performed under general anesthesia. Electrodes are implanted in the targeted brain areas, and the pulse generator is placed under the skin of the chest.
- Programming and adjustment: After surgery, the DBS device is programmed and adjusted to deliver optimal electrical impulses based on the patient's needs.
- Follow-up care: Regular follow-up appointments are necessary to monitor and adjust the DBS settings.
Cost of DBS:-
- Cost of neurostimulator: Around Rs 12 lakh.
- Additional surgical costs: In private hospitals, the total cost can rise to around Rs 17 lakh.
- Cost of brain surgery: Usually between Rs 20,000 and Rs 30,000.
How a brain implant works
Neurostimulator device:-
- This device delivers continuous electrical impulses to the brain to interrupt abnormal seizure-causing signals.
- It is a 3.5 cm square and 0.6 cm thick device surgically implanted in the skull.
- Two electrodes are inserted deep into the brain, reaching the thalamus.
- The electrodes are connected to a neurostimulator, which is anchored using screws.
Conclusion:-
- The first brain implant to control epileptic seizures represents a significant advance in the treatment of epilepsy.
- Although it is not a first-line treatment, DBS offers a promising option for people resistant to conventional treatments.