We are proud to host the only comprehensive Epilepsy Neurosurgery Program in the province of Manitoba. Pediatric and adult patients with medically intractable epilepsy may be referred to our centre, where they undergo systematic review by a specialized multi-disciplinary team comprised of epilepsy-trained neurologists (epileptologists), neuroradiologists, nuclear medicine specialists, neuropsychologists, EEG technicians, epilepsy-trained nurses and the province’s only epilepsy fellowship-trained neurosurgeon, Dr. Demitre Serletis. Since 2016, this team meets bi-monthly in a Refractory Epilepsy Conference to review pediatric and adult epilepsy cases for potential surgical candidacy. The Epilepsy Neurosurgery Program at the University of Manitoba benefits from the latest advances in invasive EEG monitoring and surgical techniques, particularly for pediatric cases, owing to the recent development of a 'Pediatric Epilepsy & Pediatric Neurosurgery Program' which includes a brand-new Epilepsy Monitoring Unit for pediatric patients (please follow the link here for more details).
In terms of surgical expertise and capacity, our program is expanding steadily in its ability to offer invasive EEG monitoring procedures, including stereoelectroencephalography (SEEG), referring to the safe and minimally-invasive surgical implantation of customized electrodes into the depths of the brain for seizure monitoring. This procedure has been used in Europe for over 50 years, but has only recently emerged in a small number of North American centres. We also use conventional grid electrodes to capture electrical seizure activity directly from the surface of the brain. Either of these techniques may be used to identify a potential seizure focus over the course of a short in-hospital admission, and they also permit clinical testing to ensure that resection (or disconnection) may by safely achieved. Once a seizure focus is safely identified, patients are scheduled for surgical resection of that region of the brain, in the hopes of achieving seizure freedom.
The Epilepsy Neurosurgery Program at the University of Manitoba offers the complete array of surgical techniques for properly screened patients with medically refractory epilepsy. In many cases, procedures may involve surgical removal or disconnection of an epileptic focus (or region) of the brain, as is performed in lesionectomies, temporal resections and extra-temporal resections. In rarer cases, a larger hemispherectomy procedure is indicated, reserved for challenging and very severe types of epilepsy. In patients where surgical removal or disconnection is not feasible, palliative interventions may include either corpus callosotomy or the implantation of a neurostimulator device, such as the vagal nerve stimulator (VNS).