Epilepsy
Epilepsy is a neurological disorder in which a person has a tendency to experience recurrent, unprovoked seizures caused by abnormal bursts of electrical activity in the brain.
Dr. Sanjeev Srivastava specializes in the surgical management of drug-resistant (refractory) epilepsy. His clinical approach focuses on eliminating or significantly reducing seizure frequency using targeted surgical interventions tailored to the location and nature of the patient’s seizure focus.
Core Epilepsy Conditions & Surgical Modalities Treated
Temporal Lobe Epilepsy (Mesial Temporal Sclerosis): Managed via anterior temporal lobectomy or amygdalohippocampectomy to resect the seizure focus in the temporal lobe.
Lesional Focal Epilepsy: Caused by identifiable structural lesions such as cavernous malformations, focal cortical dysplasia, or low-grade tumors, treated through precise lesionectomy.
Multifocal & Eloquent Cortex Epilepsy: Cases where the seizure focus cannot be safely resected due to proximity to speech or motor regions, managed using neuromodulation techniques (RNS, VNS, or Thalamic DBS).
Atonic Seizures (“Drop Attacks”) & Severe Hemispheric Disease: Managed through disconnection procedures like corpus callosotomy or hemispherotomy to prevent rapid seizure propagation across hemispheres.
Deep-Seated Seizure Foci: Managed via minimally invasive Laser Interstitial Thermal Therapy (LITT) to ablate hyperactive tissue through a tiny keyhole entry.
Treatment Approaches & Clinical Goals
| Category | Primary Procedures | Target Conditions | Primary Goal |
| Resective Surgery | Temporal Lobectomy, Lesionectomy | Temporal Lobe Epilepsy, Cortical Dysplasia, Cavernomas | Complete seizure freedom |
| Disconnective Surgery | Corpus Callosotomy, Hemispherotomy | Atonic Drop Attacks, Severe Single-Hemisphere Disease | Halt seizure propagation & prevent falls |
| Neuromodulation | Responsive Neurostimulation (RNS), VNS, Thalamic DBS | Refractory Focal or Multifocal Epilepsy | Reduce seizure frequency & severity |
| Ablative (MIS) | Laser Interstitial Thermal Therapy (LITT) | Deep-Seated Foci, Hypothalamic Hamartomas | Minimal invasive tissue thermal ablation |
Diagnostic & Surgical Workflow
Phase 1: Non-Invasive Diagnostic Evaluation
Video-EEG monitoring, high-resolution 3T Epilepsy-protocol MRI, PET/SPECT scans, and neuropsychological testing
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Phase 2: Invasive EEG Mapping (sEEG)
(If Phase 1 is inconclusive) Stereo-EEG depth electrode placement to precisely delineate the boundaries of the epileptogenic zone
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Cortical Mapping & Eloquent Cortex Preservation
Functional MRI and electrical stimulation mapping to identify and preserve motor, language, and memory functions
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Definitive Surgical Treatment
Targeted resection, disconnection, LITT ablation, or neuromodulation device placement based on mapped diagnostic data