Empowering Yourself for Epilepsy Surgery: The Role of Prehabilitation

The decision to go ahead with epilepsy surgery is not one that is taken lightly. You will have spent years living with seizures, trialing numerous medications and battling their side-effects. You will have had extensive work-up from your neurology care team and been advised about the potential benefits and risks of choosing a surgical approach. Understandably you want to do everything you can to maximise your chances of having a good recovery. This is where epilepsy surgery prehabilitation comes in. In this article, we will be taking a look at this latest treatment advancement and exploring what it offers to patients who are considering choosing epilepsy surgery.

What is Epilepsy Surgery Prehabilitation?

Maybe you have come across the term 'cognitive rehabilitation'? This is the umbrella term for a whole host of interventions which aim to improve a person's cognitive functioning after they have had some kind of injury to the brain. Cognitive functioning refers to a whole host of different thinking skills such as memory, language, and attention.

Prehabilitation is the term used to describe using these techniques before the 'injury' occurs (in this case removing some of the brain tissue in surgery). This means that it is possible to make use all of the intact thinking skills, before any might be damaged, to establish compensatory strategies and routines prior to surgery in preparation for postoperative changes. In short, it allows an individual to make the most of their intact abilities before they are lost. This means they can really get to grips with the strategies they'll need so that they are ready to go as soon as they are needed.

Why is Epilepsy Surgery Prehabilitation Needed?

Epilepsy surgery is an incredible, sometime literally life-saving, intervention. Unfortunately, it is not without risks. One of the biggest risks that can occur that a person loses some of the cognitive functioning. This can happen irrespective of whether there has been any improvement in the number of seizures a person has. Perhaps their memory is not as reliable as it used to be, or maybe they struggle to find the words to express themselves.

These sorts of cognitive changes can have massive implications for an individual as they navigate their life post-surgery. If they are not supported with the right tools and strategies to help them manage these changes, there is a risk of the person struggling emotionally and even becoming depressed. This phenomenon is known as 'the burden of normality', which I have researched previously.

What is involved?

There are five steps to successful prehabilitation:

1. Predicting the post-surgical strengths and weaknesses

The backbone of any course of epilepsy surgery prehabilitation is a thorough neuropsychological assessment of an individual's cognitive strengths and weaknesses. You can learn more about what is involved in a neuropsychological assessment here.

2. Feedback and Evaluation

When this has been completed by a specialist clinical psychologist, they will be able to provide the patient with evidence-based predictions about whether their different types of thinking skills will be better, worse, or about the same.

3. Map the anticipated cognitive changes onto everyday life

Once the psychologist has this detailed picture of likely outcomes, then they can create a bespoke package of strategies that will reduce the impact of any cognitive loss on the person's life. To be clear, prehabilitation cannot stop the loss of function from happening but it can provide alternative strategies and skills so that the individual does not feel disabled by these changes.

4. Devising bespoke solutions to the predicted challenges

The psychologist will work closely with the person to devise goals that are important to their individual life. An actor might prioritise ways to remember new scripts, whereas someone working in PR might value recalling names and faces. The psychologist will work closely with the person to offer tailored solutions based upon anticipated problems highlighted by their neuropsychological assessment. They will also offer broader lifestyle advice known to support people to develop a good quality of life after their surgery.

5. Implement prehabilitation

The final stage of prehabilitation involves the person practicing and putting in place the necessary routines prior to surgery so that they are already familiar with using the tools they will need after the operation.

Where can I access it?

Epilepsy surgery prehabilitation is a new innovation in healthcare. Traditional cognitive rehabilitation can be accessible as part of your post-surgical care from your neurology team, but you may find prehabilitation more difficult to access. Speak with your care provider to see what they offer or get in touch with us today to book your first session.

Conclusion

Epilepsy surgery prehabilitation is a vital component of the journey toward seizure-free living. It's a proactive and empowering process that aims to optimize your physical, mental, and emotional well-being before undergoing epilepsy surgery.

By working closely with your psychologist you're setting yourself up for a smoother and more successful experience. These early preparations can also contribute to improved post-surgery recovery and quality of life.

If you are considering taking this treatment then remember, your participation in the prehabilitation process is a significant step toward taking control of your epilepsy and taking charge of your future. Embrace the support, guidance, and resources available to you, and approach epilepsy surgery with confidence and courage.

Author Bio:

Dr Emily Shah is a Clinical Psychologist specialising in Neuropsychology. She works in the NHS and in private practice, offering in-person appointments in North-West England and online consultations across the UK.