Epileptic surgery a first in Indonesia<\/p>\n
By Bengawan<\/p>\n
SEMARANG (JP): The parents were ecstatic when their second
\nchild, Maria, was born 34 years ago. She looked just like other
\nhealthy babies. They had no inkling that Maria would be afflicted
\nwith epilepsy.<\/p>\n
"When she was about one year old, Maria started having
\nfrequent spasms, at least four times a month. A medical checkup
\nfound that she had epilepsy," her sister Lee Hwa said at
\nTelogorejo Hospital in Semarang last Sunday.<\/p>\n
Despite the epilepsy, Maria graduated from Dharma Putra high
\nschool in her hometown of Salatiga in Central Java. She did not
\npursue a higher education, instead helping out at the family's
\nbakery.<\/p>\n
Lee Hwa said her sister was examined at a Bangkok hospital 10
\nyears ago, and three years ago she was examined in Singapore. But
\nthere was no improvement in her condition.<\/p>\n
"In March 1999, Maria sought treatment with neurosurgeon Dr.
\nZainal Muttaqin at Telogorejo Hospital. He suggested an
\noperation," Lee Hwa said.<\/p>\n
A preoperation examination with a video electroencephalograph
\n(EEG) and magnetic resonance imaging (MRI) showed a stain on one
\nof the nerves in the left side of the brain. "The stain will be
\nremoved by the operation," said Lee Hwa.<\/p>\n
The operation was successfully carried out last Sunday thanks
\nto the cooperation between the Association of Neurosurgeons and
\nthe Association of Neurologists in Semarang. In fact, it was the
\nfirst operation of its kind in Indonesia.<\/p>\n
"In Europe such operations were being performed 10 years ago,"
\nDr. Zainal said. "Indonesia has only 56 neurosurgeons and they
\nare overworked. Besides, they are not evenly distributed
\nthroughout Indonesia. However, I hope this operation will spread
\ninformation on epilepsy to all the neurosurgeons here," he said.<\/p>\n
The operation on Maria was indeed an educational forum for 15
\nprospective neurosurgeons from Jakarta, Bandung and Surabaya.
\nProfessor Kazunori Arita of Hiroshima University in Japan, Dr.
\nZainal Muttaqin's mentor, came to Semarang to lead the operation,
\nwhich began at 3 p.m. and lasted some four hours.<\/p>\n
A workshop on epilepsy surgery was held at the hospital before
\nthe operation. Dr. R.B. Wirawan, a neurologist at Diponegoro
\nUniversity's School of Medicine in Semarang, said epilepsy was
\nnot a hereditary disease.<\/p>\n
"Possibly only 8 percent of epilepsy cases are hereditary," he
\nsaid.<\/p>\n
According to Dr. Wirawan, there are several types of epilepsy,
\na disorder which causes the patient to lose consciousness,
\nexperience spasms, bleeding from the mouth, incontinence and
\ncomma. Some patients might suffer confusion and frequently drop
\nobjects. Other patients might exhibit strange behavior, babble or
\nrun around. Hallucinations can also occur.<\/p>\n
Dr. Zainal said epileptics' intellect was hampered as a result
\nof the disorder. "Epilepsy disturbs the working of the nerves in
\nthe brain. Each spasm will add to the number of damaged brain
\ncells and disturb the brain's function."<\/p>\n
If the patient often suffers convulsions, their intellect will
\nbe seriously impaired and they may be committed to a mental
\nhospital, he said.<\/p>\n
Dr. Zainal said, however, epilepsy could be effectively
\ntreated, adding that treatment can be considered a failure if
\nstandard antiepilepsy drugs have been given individually or in
\ncombination for two years and convulsions still occur or drug
\ntoxicity takes place. Seventy percent of epilepsy cases can be
\novercome by drugs; the remainder can only be cured by an
\noperation, he said.<\/p>\n
Dr. Zainal said the operation removed brain tissue which had
\nbeen damaged by continual convulsions. After the operation, the
\npatient is not entirely cured and will continue to receive
\nantiepilepsy drugs for six more months. The dosage is gradually
\nreduced over a period of three years. "In that period it will be
\nknown whether the patient is cured of epilepsy. Medication will
\nonly be completely stopped after three years if the patient is
\ndeclared cured."<\/p>\n
When asked about the cost of the operation, Dr. Zainal said it
\nwas not prohibitive. "It does not cost much. It is nearly the
\nsame as other neurosurgeries, including brain operations
\nnecessitated by accidents. The cost for third-class patients is
\nabout Rp 3 million for drugs, the operating room and the doctors.
\nFirst-class patients pay twice or three times as much."<\/p>\n
The MRI costs Rp 1 million and can only be taken in Jakarta
\nand Surabaya. The EEG is only Rp 10,000.<\/p>\n
Maria spends Rp 1.2 million a month on drugs. Before the
\nmonetary crisis the drugs cost Rp 400,000.<\/p>\n
Data presented by Dr. Zainal showed that generally 50 to 60
\npeople from a population of 100,000, or 0.05 percent, suffered
\nfrom epilepsy. Of that number, 20 percent to 40 percent cannot be
\ncured by standard antiepilepsy drugs. The United States has
\n150,000 new cases of epilepsy every year and two thousand to five
\nthousand of these patients must be operated on to cure their
\nepilepsy. Statistically, there must be a large number of epilepsy
\ncases in Indonesia, with a population of more than 200 million.<\/p>",
"url": "https:\/\/jawawa.id\/newsitem\/epileptic-surgery-a-first-in-indonesia-1447893297",
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