Drug-resistant epilepsy

Epilepsy is a common condition, affecting nearly 1% of the population. In around 30% of cases, it fails to respond to antiepileptic medication. The Refractory Epilepsy Centre at Cliniques universitaires Saint-Luc treats more than a thousand such patients.

There is not just one kind of epilepsy but many different forms, the symptoms of which depend on the affected area or areas of the brain. As Dr Susana Ferrao Santos, Head of the Refractory Epilepsy Centre at Cliniques universitaires Saint-Luc explains, “Each patient must first be assessed. The aim is to confirm or refine the diagnosis of epilepsy and determine in which area of the brain it originates and manifests itself”.

This assessment always includes MRI (magnetic resonance imaging) and Video EEG (electroencephalogram with video recording). Other advanced examinations may also be considered with a view to possible surgery. All these examinations can be carried out at Cliniques universitaires Saint-Luc.

What is refractory epilepsy?

“For epilepsy to be considered refractory, the patient must have tried at least 2 antiepileptic medications for around a year without successfully halting seizures or at least achieving a clear reduction in the problems caused by the symptoms”, Dr Ferrao Santos explains.

In order to diagnose and treat epilepsy, the Refractory Epilepsy Centre calls on a multidisciplinary team composed of epileptologists (neurologists specialising in epilepsy), neurosurgeons, neuropsychologists, neuropaediatricians, psychiatrists, medical imaging specialists and others.

Treatment of refractory epilepsy

Depending on the results of the assessment, a number of treatments may be considered:

• Classic surgical techniques such as resection, disconnection, subpial transections or callosotomy.  These techniques aim to normalise the electrical activity in the brain by destroying or disconnecting the epileptic focus from the rest of the brain.
• In vagus nerve stimulation, the vagus nerve – one of the cranial nerves – is stimulated by means of low-voltage electrical impulses.
• Deep brain stimulation involves the surgical placement of two electrodes in a precise, deep area of the brain.

International patients

Cliniques universitaires Saint-Luc Refractory Epilepsy Centre regularly welcomes patients from abroad. “We see patients who have undergone surgery again 3 months after their treatment” explains Dr Ferrao Santos. “Long-term monitoring can then be carried out in their home country with their neurologist.”