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Aura origins show the way in epilepsy surgery

Epileptic seizures are often preceded by auras, which patients experience in many ways: visual disturbances, butterflies in the stomach, or even déjà vu. An aura can reveal which part of the brain is spawning a seizure, but multiple auras in a person have heretofore offered little guidance to doctors.

A new study finds, however, that multiple auras tend to originate in the right hemisphere of the brain, often from an identifiable starting point. Pinpointing the trouble spot has now enabled surgeons to remove it in some patients.

Such brain surgery is usually reserved for epilepsy patients with single auras whose seizures can't be controlled with medication. Patients with multiple auras, which are assumed to originate from multiple trouble spots, have been considered poor candidates for surgery, says study coauthor Prakash Kotagal of the Cleveland Clinic.

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