Sumeet Vadera, MD

“Rather than doing a large craniotomy, large incisions, taking a large piece of the bone, large resections—a lot of these things, we can do with minimally invasive techniques.”

Sumeet Vadera, MD, associate professor of neurosurgery, and director, epilepsy surgery, UC Irvine, told 

 annual meeting of the American Epilepsy Society (AES)

, December 6-10, 2019, in Baltimore, Maryland, that while there will most likely always be a place for open surgery in epilepsy, many of the advances that have been made prevent its need for a large number of patients.

These advancements include focused ultrasound, deep brain stimulation, percutaneous implantation, and neuromodulation, and they’ve allowed for surgeons and clinicians to improve outcomes for patients without undergoing more major surgery. One of the methods Vadera and colleagues use the most is responsive neurostimulation, due to its ability to address unresectable areas of the brain.

He also shared his insight into how these minimally invasive procedures have aided improved outcomes for patients, particularly cognitive ones, sometimes even more effectively than open surgery. While it’s still early in these processes, Vadera shared how these methods have pushed the field forward.

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The director of epilepsy surgery and associate professor of neurosurgery at UC Irvine spoke to the advances that have been made in epilepsy surgery and in noninvasive or minimally invasive techniques, as well as the impact they’ve had on outcomes.

Sumeet Vadera, MD: Advances in Epilepsy Surgery

“Epilepsy is a pretty devastating disease. It affects not only the patient, but the family and the friends, and the whole entire social circle.”

Patients with epilepsy can in some cases have surgical procedures, both invasive and minimally invasive, which can result in their freedom from seizures, essentially curing them of their epilepsy. However, the number of candidates who undergo these surgeries remains lower than expected.

For epilepsy surgeons such as Sumeet Vadera, MD, associate professor of neurosurgery, and director, epilepsy surgery, UC Irvine, this is a painful truth. At the 

, December 6-10, 2019, in Baltimore, Maryland, he told 

 of the consequences that patients can face by forgoing such procedures—most notably that uncontrolled seizures remain uncontrolled.

Additionally, he said, there are often fears about patients getting lost in the system when they leave the comfort of their epileptologist’s care for care in a surgical center. Getting patients referred to a Level 4 surgical center such as UC Irvine’s can help, Vadera said, as these centers are well-equipped. As well, he and his colleagues seek to ensure communication and collaboration with their main provider.

The director of epilepsy surgery and associate professor of neurosurgery at UC Irvine spoke about the consequences of patients choosing to forgo beneficial surgery and the importance of communication between surgeon and epileptologist.

Sumeet Vadera, MD: The Consequences of Forgoing Epilepsy Surgery

“One of the biggest hindrances to people getting surgery is the fact that there’s a lot of misinformation about surgery, in general, out there. I’ve had patients come to me, and they say that their primary doctor or their neurologist said they’d become paralyzed, they’ll be blind—that they can become a zombie if they have surgery.”

Epilepsy surgery has come a long way since its inception, with many procedures now being minimally invasive. When possible to conduct, it can result in complete seizure freedom for 50% to 80% of patients, Sumeet Vadera, MD, associate professor of neurosurgery, and director, epilepsy surgery, UC Irvine, told 

, December 6-10, 2019, in Baltimore, Maryland.

Despite this, however, many patients who are viable candidates for surgery still do not get the procedure for various reasons—many due to unfortunate misconceptions about the possible outcomes. “Nowadays, epilepsy surgery is very safe. The benefits far outweigh the risks with the surgery. It’s one of the few things we can do in neurosurgery that actually cures someone,” Vadera said.

Its benefits, he explained, can include not just seizure freedom and all that comes along with it, but improvement in the quality of life and depression scores, as well as cognitive function. To find out more about these barriers which are preventing more people from undergoing surgery, 

The director of epilepsy surgery and associate professor of neurosurgery at UC Irvine discussed the challenges he has encountered in getting patients with epilepsy to undergo beneficial procedures, often due to misinformation.

Author | Sumeet Vadera, MD

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Sumeet Vadera, MD: Advances in Epilepsy Surgery

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