What Is Epilepsy?
Epilepsy is a neurological disorder/condition characterized by recurrent, unprovoked seizures/convulsions. These seizures are caused by sudden abnormal electrical activity in the brain and can manifest in various ways, including loss of awareness, repetitive twitching or jerking movements (convulsions), involuntary movements, muscle stiffening, or sudden behavioral changes.
While approximately 70 percent of patients achieve seizure freedom with appropriate anti-seizure medications, a significant number develop drug-resistant epilepsy (DRE). DRE is diagnosed when seizures persist despite the careful use of two well-tolerated and properly chosen anti-seizure medications. For the 30–40 percent of patients with DRE, one-third of these patients may be eligible for surgical management aiming at complete seizure freedom or reduction in seizure frequency.
Children with uncontrolled seizures can develop a serious condition called epileptic encephalopathy, which manifests as developmental delays, regression in milestones, and cognitive or behavioral impairments. The International League Against Epilepsy recommends timely and effective surgical intervention for patients with DRE who are candidates for surgery to prevent the complications of encephalopathy.
EPILEPSY CARE AT CURE UGANDA
Recognizing this need, CURE Children’s Hospital of Uganda, in collaboration with other partners, now offers a comprehensive Pediatric Epilepsy Surgery Program. The patient undergoes a thorough presurgical workup, and each case is discussed in detail by the dedicated multidisciplinary team meeting and a clear surgical plan is laid down for successful candidates.
PRESURGICAL WORKUP
Each patient undergoes a thorough medical evaluation, including diagnostic testing such as prolonged video EEG and MRI or CT scans. The results are then reviewed by a team of specialists, including pediatric neurologists, neurosurgeons, neuroradiologists, and EEG technologists, among others.
SURGICAL PROCEDURES
CURE Uganda’s neurosurgical team is experienced in performing a range of advanced procedures that include:
- Lesionectomy: Removal of a specific brain lesion (e.g., a tumor or malformation) causing seizures
- Lobectomy: Removal of a portion of a brain lobe, most commonly the Temporal Lobectomy or Frontal Lobectomy, where seizures often originate
- Functional Hemispherectomy: A specialized procedure that disconnects the affected hemisphere of the brain to stop seizures while preserving vital functions
- Posterior Quadrant Disconnection: A procedure that involves disconnecting the temporal, parietal, and occipital lobes from the rest of the brain to prevent the spread of seizures
What issues do children with epilepsy face?
LIFE-THREATENING
A patient with epilepsy can develop a condition called status epilepticus, which causes prolonged or multiple seizures that can lead to permanent brain injury or death.
STIGMA
Children and their families often experience discrimination, leading to poor self-confidence and isolation.
DEVELOPMENTAL DELAYS
Neurological impacts may include lack of coordination, loss of motor function, and delayed social development.
How does surgery change a child’s life?
For many families, medically resistant epilepsy brings enormous challenges, including constant seizures, high medication costs, difficulty finding some drugs, high drug burden and associated side effects.
Surgery can reduce seizure frequency—or even achieve seizure freedom—improving quality of life while lowering medication costs and the overall drug burden.
