Q: I suffer from complex partial seizures since 6 years. Recently I got an MRI done and the report reads as follows: Supratentorial region - head and body of right hippocampus is slightly decreased in size with subtle signal changes and shows mild prominence of adjacent CSF spaces. Impression: mild atrophy with subtle signal changes involving head and body of right hippocampus - mesial temporal sclerosis. Subsequently I underwent spinoidal EEG and neuro-psychology which confirmed the diagnosis. Sir, at present my problem is that I have ususally get mild attacks with big ones being rare. But these are frequent (almost every second day) and affect my daily routine. The neuropsychology report says that I have memory deficit and my IQ has come down from 90 to 75. I am at present taking Tegrital (200mg) 1-1-2 since 2 years; Eptoin (100mg) 1-0-1 since 3 months; Fresium (10mg) 1-0-1. I have mainly a memory problem now and my exams are due in 2 months. Is surgery necessary? Should I go in for it and what would be the cost?

A:If you have managed to write all of this I do not think that you could be having an IQ very far from normal. However, it is true that frequent, even partial attacks can effect learning, can be disabling socially and impair psychosocial development. The particular type of problem that you have is known to be quite resistant to drugs. Surgery is known to be extremely effective in controlling the fits. It appears that drugs have been tried out adequately in your case and you would seriously have to consider surgery. The cost of surgery would partly depend on the investigations before the operation to be absolutely sure that the diseased area is the source of the attacks. You seem to be already investigated extensively. The operation itself should cost about Rs 50,000 to 80,000 depending on the room category in a private hospital like Sir Ganga Ram Hospital at New Delhi.