Multiple Subpial Transections MST Treatment

Who Is a Candidate for Multiple Subpial Transection?

A great many people with epilepsy can control their seizures with medications. Around 20% of individuals with epilepsy don't get relieved from symptoms with the help of prescription drugs. At times, surgery to remove the part of the brain causing the seizures might be prescribed.

MST might be a possibility for individuals who don't respond to medication and whose seizures start in areas of the brain that can't be securely removed. Moreover, there is a possibility that the individual will benefit from surgery. MST might be done alone or with the removal of a section of brain tissue (resection). MST likewise might be used as a treatment for children with Landau-Kleffner syndrome (LKS), an uncommon child brain disorder which causes seizures and affects the parts of the brain that control speech and comprehension.

What Tests are Performed Before Multiple Subpial Transection?

Prior to medical procedure, the area of brain where the seizures begin should be recognised. This may include:

• X-ray An MRI utilises vast magnets, radio waves and a PC to make pictures of the inner side of the body.
• CT Scan This test uses a progression of x-rays and a PC to make pictures of within the body. A CT scan provides more detail than a standard x-ray scan.
• EEG (outpatient) This test records the brain's electrical movement through sticky patches (anodes) connected to the scalp.
• EEG (inpatient) Some patients may require a more extensive EEG to record electrical movement in which case a stay in the hospital will be necessary.
• MEG Filter MEG, or magnetoencephalography, is a non-invasive test used to detect seizures and abnormal movement inside the brain using magnetic sensors. MEG can also be used to study those regions of the brain that control engine, tangible and dialect.

What Happens During Multiple Subpial Transection?

MST requires exposing an area of the brain using a procedure called a craniotomy. ("Crani" refers to the skull and "otomy" signifies "to cut into.") After the patient is put to sleep with anaesthesia, the specialist makes an incision (cut) in the scalp, removes a bit of bone and pulls back an area of the dura, the intense film that covers the brain. This makes a "window" in which the specialist embeds his or her surgical instruments. The specialist uses information gathered amid pre-surgical brain imaging to help distinguish the territory of abnormal brain tissue and avoid areas of the brain in charge of vital functions.

Utilising a surgical microscope to create a magnified view of the brain, the surgeon makes a series of parallel, shallow cuts (incisions) in gray matter, just underneath the pia mater (subpial), the sensitive film that surrounds the brain (it lies underneath the dura). The cuts are made over the entire area which is recognised as the source of the seizures. After the transactions are made, the dura and bone are fixed back into place, and the scalp is closed using stitches or staples.

What Risks Are Associated with Multiple Subpial Transection?

The dangers related with MST include:

• Risks related to surgery, including infection, bleeding
• An allergic reaction to anaesthesia
• Inability to relieve seizures
• Swelling in the brain
• Damage to healthy brain tissue

Prognosis

MST is a safe method with moderate success rate. It has been used primarily in conjunction with cortical resection or lesionectomy, when the cortex is associated with the seizure activity. Prospective studies are needed to define the role of MST in epilepsy surgery.