A 30-year-old German man suffering from refractory post-traumatic stress disorder (PTSD) and dyscognitive epilepsy was successfully treated by the doctors here via a rare keyhole surgery.
Refractory PTSD with dyscognitive epilepsy refers to a complex medical condition where an individual experiences both PTSD and epilepsy characterised by memory intrusions, inability to focus, avoiding situations and contacts that remind of traumatic experiences, isolation, and difficulty in establishing and maintaining relations.
“Refractive PTSD is termed when a patient suffering from regular PTSD doesn’t respond to any medication. This leads to a complex syndrome in which the patient has uncontrollable, continuous intrusions in the form of PTSD and develops other associated disorders. In this case, the patient developed dyscognitive epilepsy as a result of refractory PTSD,” Dr Himanshu Champaneri, Senior Consultant Neurosurgeon at Marengo Asia Hospital, Gurugram, told IANS.
The man endured multiple traumatic experiences from childhood till his teenage due to domestic abuse. As a result, he started experiencing PTSD symptoms from the age of 17.
Later, he also developed dyscognitive epilepsy due to which he had sudden episodes of blankness when he would lose the ability to respond to his surroundings, questions, or any dangers.
Such episodes would occur anytime when he was travelling, standing at the subway station, in class, or even alone, and affected his daily life as he was unable to pursue any growth in his education/profession.
“When someone has both refractory PTSD and dyscognitive epilepsy, it can pose significant challenges in diagnosis and treatment. The presence of one condition can exacerbate the symptoms of the other, leading to a complex clinical picture,” Champaneri told IANS.
The patient had sought medical therapies before coming to India, which helped him for a certain time, but the symptoms recurred. He even attempted suicide two times.
At Marengo Asia, the doctors asked him to revisit his traumatic memories, and his functional MRI showed active signals in the right amygdala, which is expected in cases of severe refractory post-traumatic stress disorder.
The keyhole surgery was performed using stereotactic radiofrequency ablation.
“Managing this condition typically involves a multidisciplinary approach, including mental health professionals, neurologists, and other specialists, to address both the psychiatric and neurological aspects of the disorder. The treatment may involve a combination of medication, psychotherapy, and possibly other interventions such as neuromodulation or lifestyle modifications,” Champaneri said.
“After the surgery, the patient remained in a very relaxed and happy state and was able to focus on tasks that had not been possible before. He did not have any episodes of dyscognitive seizures after the surgery and had complete relief from the post-traumatic stress disorder,” the doctor said.
