Anaesthetic considerations in epilepsy surgery

Abstract

pilepsy is the most common neurological disorder in adults and children. It is a major cause of serious public health problems and can interfere with educational opportunities, social relationships, employability and family dynamics. The approximate annual incidence rate is 40-70 per 100,000 in industrial countries and 100-190 per 100,000 in resource poor countries. Up to 5% of people experience non-febrile seizures at some period of their life (1). Most patients can be managed medically. However 30% of people with epilepsy do not have seizure control even with the best available medications. (2),(3) Some of these patients may benefit from epilepsy surgery. The complications include memory loss, speech and language impairment. Therefore it is essential to weigh the benefits and risks of surgery in this group of patients. Medically intractable epilepsy Definition-Failure to control epilepsy by first or second line drugs with two or more trials. Patients with refractory epilepsy have to be assessed by the multidisciplinary group which include neurologist, neurosurgeon, psychiatrist, neuropsychologist, neuroradiologist and anaesthetist.