Epilepsy Surgery Unit
Research and Innovation
Welcome to the Epilepsy Surgery Unit of Hospital Ruber Internacional
Epilepsy is a neurological condition affecting millions of people worldwide, significantly impacting the quality of life of both patients and their families. This condition manifests through epileptic seizures, which are episodes of abnormal and excessive electrical activity in the brain. These seizures can appear in various forms, depending on which areas of the brain are involved and what functions are affected.
The primary goal of surgical techniques used in epilepsy surgery is to eliminate the epileptic focus or prevent the spread of abnormal discharges in the brain. These interventions are especially beneficial for patients with refractory or drug-resistant epilepsy—those who have not achieved seizure control with conventional medications.
At Ruber Internacional, we are leaders and pioneers in treating this complex neurological condition. We have a multidisciplinary team of highly qualified experts recognized nationally and internationally, including Dr. Antonio Gil-Nagel and Dr. Marcelo Budke, who are globally renowned for their excellence in epilepsy research and treatment.
Our specialists are committed to providing effective, personalized solutions for the accurate diagnosis of epilepsy and its surgical treatment using the most advanced procedures and technologies worldwide.
If you have any questions or would like to learn more about our services, specialists, or any aspect related to the Epilepsy Surgery Unit at Hospital Ruber Internacional, please do not hesitate to contact us.
- Epilepsy Surgery Unit TeamTeam Leader: Dr. Antonio Gil-Nagel ReinHospital Ruber InternacionalSpecialty: Epilepsy Surgery Unit91 387 52 50
Research and Innovation in Epilepsy Treatment
Epilepsy surgery is considered a treatment option when antiepileptic medications fail to adequately control seizures. Not all epilepsy patients are candidates for surgery, but it can be beneficial in specific cases.
The decision to perform epilepsy surgery depends on the location and size of the epileptic focus—the region of the brain responsible for triggering seizures. At the Epilepsy Surgery Unit of Hospital Ruber Internacional, our multidisciplinary team of experts is dedicated to carefully evaluating each case to determine the best surgical strategy for each patient.
Among the surgeries we perform for epilepsy treatment are:
- Laser Thermoablation: A non-invasive procedure that uses laser energy to destroy or eliminate epileptogenic brain tissue, which triggers seizures.
- Deep Electrodes: Stereoelectroencephalography (stereo-EEG) is used to place electrodes in deep brain areas to record electrical activity. Additionally, thermocoagulation can selectively destroy specific brain areas causing seizures.
- Gamma Knife Radiosurgery: A radiotherapy technique that uses gamma radiation beams to target precise brain areas where epilepsy originates, without requiring invasive surgery.
- Temporal Lobectomy: As previously mentioned, this involves removing a portion of the brain’s temporal lobe when the epileptic focus is located in this area.
- Extratemporal Resection: This refers to the removal of epileptogenic areas in brain regions outside the temporal lobe, such as the frontal, occipital, or parietal lobes.
- Hemispherectomy: Involves the removal or complete disconnection of one brain hemisphere, typically performed in severe cases of refractory epilepsy localized to one hemisphere.
- Functional Hemispherectomy: In this procedure, specific brain areas are selectively disconnected rather than removing an entire hemisphere, to control seizures while preserving essential functions.
- Disconnection via Endoscopy: Using an endoscope, abnormal neural areas contributing to seizures are disconnected.
- Electrical Stimulation through Vagus Nerve Stimulation (VNS): A device is implanted to stimulate the vagus nerve in the neck, reducing the frequency and severity of seizures.
- Deep Brain Stimulation (DBS): Similar to VNS, this technique involves implanting electrodes in specific brain areas to modulate neuronal activity and control seizures.
Epilepsy surgery requires comprehensive and detailed studies to ensure accurate indication and localization of the epileptogenic focus. For this reason, these interventions must be carried out in highly specialized centers.
State-of-the-Art Technology and Expert Professionals in Epilepsy
At the Epilepsy Surgery Unit of Hospital Ruber Internacional, we work in a coordinated and multidisciplinary manner to provide the best care and outcomes for our patients. Our team of neurologists, neurosurgeons, neurophysiologists, neuropsychologists, and nursing staff are specialists in epilepsy with extensive experience managing this complex neurological condition.
Before surgery, we conduct a comprehensive pre-surgical evaluation to ensure accurate indications and localization of the epileptic focus. Our approach is based on obtaining an in-depth and thorough understanding of the patient’s medical history, their response to medication, family history, and genetic factors that may influence the condition. Additionally, we analyze symptoms during seizures and their impact on the patient’s quality of life.
After this initial consultation, our team continues to work closely with the patient through follow-up calls and reviews of prior tests and reports. Subsequently, we may recommend additional complementary tests to pinpoint the location of the epileptic focus.
Once the first stage of reviewing the patient’s medical history is complete, we proceed with specific tests to gain a deeper understanding of the epilepsy and determine the most appropriate therapeutic approach. These specific tests may include:
- Video EEG Monitoring (Video Electroencephalography, Video-EEG Monitoring, Video-EEG Telemetry)
This prolonged test records the brain’s electrical activity and observes the clinical manifestations associated with EEG changes. It is essential for identifying epileptiform abnormalities and determining the type of epilepsy (focal or generalized).
- MRI and IMR (Magnetic Resonance Imaging or Magnetic Resonance Imaging)
Magnetic resonance imaging provides detailed images of the brain, allowing the identification of possible lesions or structural abnormalities that may be associated with epileptic seizures.
- PET (Positron Emission Tomography)
This technique studies cerebral metabolism and can help identify areas with reduced glucose metabolism, indicative of the epileptic focus.
- MEG (Magnetoencephalography)
MEG is a valuable non-invasive technique that studies the brain’s cortical magnetic fields, providing useful information for localizing the epileptogenic focus.
- Deep and Subdural Electrodes
In some cases, intracranial electrodes may be used to more precisely map the affected areas and determine the epileptic focus.
The use of these specific tests allows us to obtain a comprehensive view of the case, identify the epileptic focus, and define the best therapeutic strategy for each patient.
At the Epilepsy Surgery Unit of Hospital Ruber Internacional, we conduct a complete and advanced evaluation to deliver the best outcomes for our patients.