Mater conducts Queensland’s first fully awake epilepsy brain surgery

A 24-year old Queensland man is now free of epileptic seizures after undergoing the state’s first brain surgery on a fully awake epilepsy patient.

Ben Tondeleir, who is under the treatment of Mater’s Advanced Epilepsy Service, underwent the surgery at Mater Hospital Brisbane in August this year to prevent severe and frequent seizures.

Mater Advanced Epilepsy Service Director, Dr Lisa Gillinder said the team had to try something out of the box because Mr Tondeleir had severe complications related to his epilepsy, after undergoing prior anaesthesia.

“It was critical to find a way to make this surgery possible for Ben because he has experienced up to10-15 epileptic seizures every day of his life since he was six years old, and several past surgeries had caused severe uncontrolled seizures relating to the use of general anaesthetic,” Dr Gillinder said.

“Our team is very excited by the outcome of this fully awake surgery because it’s the longest Ben has been seizure free since his diagnosis as a child.

“Epilepsy of this severity typically results in serious injuries and can be life shortening, so our team hopes that the surgery will not only improve his quality of life, but also prevents the risk of frequent ICU admissions every year.”

Patients are typically given a general anaesthetic so they are asleep during the initial part of this type of epileptic brain surgery and are awoken for testing just before and while the epileptic brain tissue is removed. The patient is then returned to sleep while the surgery is finalised. This prevents them being exposed to the more confronting parts of the surgery, like incisions, drilling and the removal of bone. 

Mater Neurosurgeon, Dr Jason Papacostas said the surgical team decided to attempt the fully awake surgery, using only local anaesthesia, because in past operations Mr Tondeleir developed status epilepticus, a potentially life-threatening condition where seizures last too long and the person can’t be roused.

“After past surgeries he was admitted to ICU because the seizures did not stop with the usual treatment – so this time the team felt the safest approach was to avoid general anaesthetic altogether, so he could remain awake for the entire surgery,” Dr Papacostas said. 

“Our team spent a lot of time preparing Ben for all of the things he might experience with only a local anaesthetic, including things like the sound and vibrations from drilling, to make sure he would be able to manage during the surgery. He did very well! Our team was very impressed by his bravery.

“This is a difficult surgery to perform, but the success of this case means our team can treat even more Queenslanders who we previously could not help.”

Ben Tondeleir said the surgery changed his life.

“I used to live in fear of having a seizure at any time, which made me feel like I had no control of my own life. Even falling asleep was frightening because I didn’t know if I would wake up days or weeks later in ICU, or not wake up at all,” Mr Tondeleir said.

“It was a relief to be awake during the surgery because it gave me a sense of reassurance because after each of my previous operations, I ended up in Intensive Care from having to be put in an induced coma.

“Epilepsy had always been like a fence that kept me on the sidelines, watching other people living normal lives. The doctors and nurses who performed my operation opened a gate for me, so I can live life to the fullest. I’m so grateful to all of the team.”

Mater’s Advanced Epilepsy Service has been conducting corrective neurosurgery to treat epileptic seizures for six years. It is a fully public service, with treatment available to all eligible patients living with epilepsy in Queensland.

The team first uses stealth navigation, intraoperative EEG (brainwave) recordings and brain stimulation to pinpoint the part of the brain that is causing seizures, and then the surgical team removes the problematic tissue.

According to Epilepsy Queensland one in ten Australians will be affected by epilepsy at some point in their life.

A third of this group will not achieve freedom from seizures with medication and may require surgery.

More than 30,000 Queenslanders currently live with an active diagnosis of epilepsy and approximately a third of this group will not achieve freedom from seizures with medication and may require surgery.

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