Multiple Auras = Good Candidate for Epilepsy Surgery

[Bernard]

Experiencing Auras? You May Be a Good Candidate for Epilepsy Surgery

ST. PAUL, Minn. – People with epilepsy who experience multiple auras, sensations such as a cold breeze or bright light before they have a seizure, may be good candidates for epilepsy surgery because their seizures seem to be coming from one area of the brain, according to a study published in the August 21, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology.

For the study, researchers examined 31 people with epilepsy who experienced multiple types of auras, such as a bad smell, psychic experience, or abdominal pain.

The study found 90 percent of patients with at least two aura types and 100 percent of patients with at least three aura types had seizures arising from the non-dominant side of their brain.

“Epilepsy surgery may be effective for people with multiple auras since most of the seizures seem to arise from one area of the brain rather than multiple regions,” said study author Prakash Kotagal, MD, with Cleveland Clinic Epilepsy Center in Cleveland, OH, and member of the American Academy of Neurology.

The study also found more than half of the 19 study participants who went on to have epilepsy surgery stopped having seizures.

Before now, researchers say little has been known about the significance of having multiple auras since most of the attention has been focused on people with single auras.

“Multiple auras may be underestimated since auras are often difficult and time-consuming to elicit from a patient, particularly if their importance is not appreciated by the patient’s doctor,” said study co-author Peter Widdess-Walsh, MD, with Saint Barnabas Institute of Neurology in West Orange, New Jersey, and member of the American Academy of Neurology. “However, our findings show multiple auras should be recognized by doctors as a significant finding and should be used in deciding whether to proceed with epilepsy surgery.”

Experiencing Auras? You May Be a Good Candidate for Epilepsy Surgery

[brain]

YES! That's what the Epileptologist last
year was telling me. I still have a chance!
*crossing fingers*

[brain]

Multiple auras may result from single epileptogenic focus

"Having multiple auras does not necessarily mean there are multiple seizure foci, so they may very well benefit from a detailed evaluation with subdural grid electrodes and eventually resection of the focus," Dr. Prakash Kotagal from the Cleveland Clinic Epilepsy Center, Ohio told Reuters Health.

SPECT in six patients with right-sided seizures showed no brainstem activation during the seizures.

[Eternal_Howl]

I get auras, and sometimes multiple auras, but I still wouldn't want the surgery. I don't think I'm 'bad' enough to warrant it and I'd be worried what else it may affect if I did have the surgery.

[Nancy]

Hi Eternal_Howl ~ That's exactly the way I felt for many years. When my seizures started in 1990 I was grateful that I thought I wasn't eligible for ~oh, how horrible~ brain surgery.

And now I'm oh, so grateful that I've had it. This surgery is easier and safer than epilepsy.

[solis]

'Aura' is just the name given to simple partial seizures if/ when they come immediately before a complex partial or a generalized seizure (when awareness is negated).

So, it would be more accurate to say that surgery is for those with partial epilepsy.

one who had surgery,
~sol

[Eternal_Howl]

Hi Nancy,
You are a brave woman! I'm sure having the surgery is safer than having E, but I guess for me, because I get warnings, it's annoying but I can work around it.

My neurologist always gave me the impression that my 'auras' were warnings and weren't seizures exactly. They were the precursor to the seizure (and that warning may occur hours before the seizure) and in my experience, this definition is correct. It's a slight shift in my perception that tells me "watch out", your brain is about to malfunction (but it hasn't yet). It's literally a warning for me - and not the seizure. My typical seizures aren't typical for most, I don't think. I get small ones more often than not (as opposed to horrible tonic-clonic convulsions that I got when I was younger). It just affects my memory and I have to wait til I'm running on all cylinders again otherwise conversation tends to be a real struggle as I try to recall what the discussion is about and surroundings appear unfamiliar. I know it's still E, but compared to what I used to have and how much worse others have it, I guess I try to see the upside to what I have, if you know what I mean. It's still a pig though!

[Bernard]

Hi solis, welcome to the forum.

BTW, if you experience auras, you might look into cognitive behavioral therapy (CBT). You might be able to learn ways to prevent seizures from happening.

[Nancy]

Hi solis ~ Wow - I'm happy to hear from someone else who has had the surgery. I'd sure be grateful to hear about it.

I used to have those "funny" simple partial seizures around 24 hours before the big complex partials started. I smelled almost over powering horrible stuff - really sickening. But I learned to not even mind too much. I could be sort of "braced" for the seizures that were coming.