Persons with epilepsy with seizures that cannot be managed or controlled by medication can undergo brain surgery within the country now. A neurosurgeon at the National Referral Hospital conducted the first in-house epilepsy surgery. Epilepsy is a non-communicable brain disorder characterised by repeated seizures. During a seizure, a person may lose control of their body movements, experience unusual sensations, or even lose consciousness.
The first in-house surgery was carried out on a 25-year-old woman. There are different kinds of surgery depending on the severity and types of epilepsy.
Neurosurgeon Dr Sonam Jamtsho and his team carried out resective surgery, the most difficult epilepsy surgery with effective seizure control post-surgery. It involves the removal of a small portion of the brain where seizures occur.
Dr Sonam Jamtsho says brain surgery is required only when medications fail to control or manage seizures.
In the case of this woman, she had repeated seizures for the past six years which could not be controlled by five different types of antiepileptic medication.
“So, when the patient is receiving almost like four to five anti-epileptic drugs, but at a higher dose and the patient still has a seizure-like more than four to five times a week or one to two times a day, we use the term as medically intractable seizure or drug-resistant seizure. In such scenarios, the role of antiepileptic drugs is minimal, meaning it’s not working at all. So in such scenarios, there is an indication for surgery,” said Dr Sonam Jamtsho.
Currently, 50 to 55 per cent of the patients that he sees in the outpatient department are people with epilepsy. Each year, around 15 to 20 patients are referred to India for epilepsy surgery.
It costs a minimum of Nu 700,000 for surgery alone for each patient.
Although the start of such brain surgery within the country is an encouraging move, it is not without its fair share of challenges.
Dr Sonam Jamtsho assembled his trained team to perform epilepsy surgery just four months ago. The epilepsy surgical team currently doesn’t have a neurologist or a medical doctor specialising in diagnosing and treating diseases of the brain, spinal cord and nerves. The team consists of a neuro anesthesiologist, two anaesthetic nurses, four scrub nurses, and a neurorecovery nurse.
“We need one neurologist. So, neurologists can basically kind of help me in treating seizure disorders with the different types of epileptic drugs. So, they specialise in treating the disease with medicines. So, they would perfectly know what kind of drugs to be used for different types of epilepsy and then manage accordingly,” said Sonam Jamtsho, a neurosurgeon, at JDWNRH.
He added that currently the hospital also does not have a neurosurgical ward and neurosurgical ICU.
According to the health ministry’s 2023 annual health bulletin, over 2,000 people in the country were diagnosed with epilepsy. 22 people died due to epilepsy between 2021 and 2022.
Samten Dolkar
Edited by Phub Gyem
