Groundbreaking brain surgery in Abu Dhabi
▶ Procedure by doctors at Cleveland Clinic Abu Dhabi involves isolating the precise area of the brain responsible for seizures and removing it
A surgical procedure to remove part of the brain responsible for epilepsy is being used to cure patients in Abu Dhabi, doctors say.
Specialists at Cleveland Clinic Abu Dhabi have performed five such operations and expect to conduct hundreds more over the next few years.
Epilepsy is the fourth most common neurological disorder and affects people of all ages. It is characterised by unpredictable seizures and can cause other health problems but symptoms vary from person to person.
Statistics on the number of people with the disorder are not available in the UAE but of the hundreds of patients hospitals see a year, about a third do not respond to medication.
Almost half of these patients who do not respond are suitable candidates for the surgery, which involves removing the area in the brain that causes seizures.
The epilepsy programme in Abu Dhabi was initiated by Dr Deepak Lachhwani, chair of the department of neurology at the hospital.
A control room with dozens of screens linked to live cameras is used by doctors in Abu Dhabi and Cleveland to monitor epilepsy patients for seizures.
“This is how we bring 100 years of experience at our doorstep,” said Dr Lachhwani. “Ohio can watch and press the seizure button if a patient is having an episode and the alarms can be heard here, so the nurse can run in and assist the patient. It is a virtual evaluation with no boundaries.”
To determine if a patient is eligible for the surgery, their brain signals are monitored in Abu Dhabi for between three days and a week.
“Brain surgery is delicate but in experienced hands it should not be feared,” Dr Lachhwani said. “Once the doctors determine the exact spot in the brain causing seizures and if it can be safely removed, the surgery is recommended.
“The surgery is a preferred treatment option for the right candidates. Epilepsy is the result of an electrical storm in the brain. We all have normal electricity in the brain but then there is a rogue area that makes electrical storms that are like a weather storm.
“When that happens, based on which part of the brain it happens in, you get the seizure and when that storm starts it has a tendency to quickly spread.
“Risks and benefits are carefully weighed for each patient,
and only when the benefits far outweigh risks is surgical treatment offered.”
He said the surgery was very safe, with less than a 5 per cent chance of complications. None of the patients who have undergone the surgery in Abu Dhabi have suffered side effects.
Dr Florian Roser, chair of neurosurgery at the Abu Dhabi hospital who performed the operations, said: “One of our patients was a teacher and has gone back to teaching, and another was a firefighter who is back on duty.
“There is always risk with any surgery but with this surgery specifically, the risk is minimal. In the UAE, many are hesitant at first but after education and seeing other patients, they change their minds.
“Many have initially resorted to faith healers and alternative therapies. The population here just needs time and to be talked to in a culturally appropriate way.”
Dr Lachhwani keeps a folder on his desk filled with pictures and thank you notes from the hundreds of patients, most of whom are children, who underwent the surgery in Ohio in the US.
More than 400 operations are performed in that branch of the hospital each year.
“I think that the trajectory for CCAD’s epilepsy programme would be at least 20 to 30 surgeries with the next two years, and perhaps in five years easily up to 100 surgeries a year,” he said.
Dr Lachhwani said sudden death was the most extreme side effect of epilepsy but the greater problems for some included psychological problems, dysfunction, not being able to attend school regularly, difficulty integrating into society and dealing with discrimination.
“All these things are a huge burden on quality of life, but now there is a cure,” he said.