A medical team at Mediclinic Constantiaberg in Cape Town will perform the first stereo-EEG procedure in South Africa on Monday, IOL reported. It will also be the first in sub-Saharan Africa.
The procedure places thin electrodes deep inside the brain. It helps doctors find exactly where a patient’s seizures start, so that surgery can be offered when medication has failed.
The first patient is a 43-year-old man whose seizures began just over a year ago. The seizures have affected his work and family life, and he can no longer drive. Several anti-seizure medicines did not control them.
“This is exactly the kind of patient SEEG was designed for,” said epileptologist Dr Aayesha Soni, who is leading the programme.
“His seizures start in one part of the brain, and medication has not worked. The question is no longer which tablet to try next. It is where his seizures come from, and whether we can safely do something about it,” she said.
According to the report, medication controls seizures for most people with epilepsy. For about one in three, it does not. Once two well-chosen medicines have failed, the chance that another one will work is very small.
For some of these patients, surgery is an option. If doctors can find the part of the brain where seizures begin, removing or treating it can stop them completely.
A normal EEG test records brain activity through small electrodes on the scalp. The skull muffles the signal, so seizures that start deep in the brain can be hard to locate.
With stereo-EEG, the team uses brain scans to plan the path of each electrode ahead of time. The paths avoid blood vessels and other important parts of the brain.
In theatre, a frame fixed to the patient’s head guides the neurosurgeon to place each electrode with millimetre accuracy. The electrodes go in through tiny holes, so the skull is never opened.
The patient is then watched around the clock, sometimes for a week or more. Medication is slowly reduced so that seizures can be recorded safely. Mild electrical signals through the same electrodes map the areas that control speech and movement.
The electrodes are later removed without a second operation.
“SEEG gives us a three-dimensional picture of a person’s epilepsy,” Dr Soni said. She said the test sometimes shows that surgery is not safe, which lets doctors move on to other treatments.
The implant takes a couple of hours, but the hospital spent more than a year planning for it. The team trained in the technique, sourced special equipment and wrote protocols based on international guidelines. It also secured funding approvals from medical schemes.
Dr Soni works with neurosurgeon Dr James Butler and Dr Sean Tromp. The wider team includes EEG technologists, radiologists, anaesthetists and nurses.
Apart from recent cases in Egypt, the procedure is not done anywhere else in Africa. Until now, South Africans who needed it had to travel abroad, which put it out of reach for almost everyone.
Epilepsy affects about 50 million people worldwide, and nearly 80% of them live in low and middle income countries. The report said most people in sub-Saharan Africa who need treatment never get it.
“People with epilepsy deserve the best care, wherever they live and whatever their means,” said Dr Soni.
Source: this article is based on reporting by IOL. Image: IOL. Written with the help of AI and published by the Tzaneen Voice News desk. See our Editorial Standards.
Kgomotso Maake covers news and politics for Tzaneen Voice. Kgomotso reports on government, Parliament, municipalities, courts, crime and service delivery across South Africa, with a close eye on how national decisions reach towns like Tzaneen and the wider Limpopo province. Stories are written in plain English and focus on the facts: who made the decision, what it means, and what happens next.