Dr. Nilesh Kurwale, Epilepsy Surgeon, Pune

Epilepsy Surgery

Wherever the art of Medicine is loved, there is also a love of Humanity. ~Hippocrates

Doctor Nilesh Kurwale is a recognized Neurosurgeon with a specialty in Epilepsy surgery. Currently, he is a Consultant Neurosurgeon and Coordinator Epilepsy Surgery Programme at Deenanath Mangeshkar Hospital, Pune.

Dr. Nilesh Kurwale is known for his expertise in various types of surgical procedures for epilepsy, which includes Mesial Temporal Lob Sx, Focal Cortical Dysplasia Sx, Resection Surgeries, Corpus Callosotomy, Vagal Nerve Stimulation, Thalamic DBS and others. He is also an expert as far as movement disorder surgeries are concerned and some of them include DBS for Parkinsons, DBS for essential tremors and dystonia along with radiofrequency lesion procedures like Pallidotomy, Thalamotony. Few other surgical procedures, which he specializes in, include Selective posterior rhizotomy for cerebral palsy, Baclofem Pump, Spinal Cord Stimulators for complex pain syndromes, Facet Nerve Ablation for backache.

One of the things that define Dr. Nilesh is the fact that he has always being empathetic towards mankind in general and through his knowledge and skills, wanted to do something worthwhile for patients. After starting his Epilepsy surgery practice, he started a comprehensive epilepsy center at Deenanath Mangeshkar Hospital to provide world-class care in epilepsy surgery at an affordable price across all strata of society.

As they say, somethings are better unplanned, Dr. Kurwale had never planned to become a doctor but medicine happened to him just by chance. However, he loved his profession from day one and has always enjoyed treating and healing people. In fact, he strongly believes that medicine is the best thing to have happened to him in his life. When a person enjoys what he does, he always does it better and this is quite the case with Dr. Nilesh.

Patient Profile
Dr. Nilesh Kurwale is known to perform surgeries on Epilepsy patients from all age groups. Last year he has performed 70 epilepsy surgeries on pediatric patients less than 12 years of age. He also performed other procedures in 10 patients who were above 50 years of age. Besides this, he performed surgeries on 15 patients between the age of 12 and 35 years. He has treated nearly 100 patients from Maharashtra whereas about 15 patients were from Rajasthan and UP. Besides this, he has also performed about 40 surgeries to help patients belonging to economically weaker sections. Dr. Kurwale has also treated 2 International patients from Oman in the last one year. He is fluent in Hindi, English, and Marathi thus enabling him to communicate freely with Indian and International patients.

Professional Achievements
Dr. Kurwale did MBBS from Government Medical College, Nagpur and MCH Neurosurgery from AIIMS, New Delhi.

He has 8 years of clinical experience and has 16 international publications attached to his name. He has given 5 conference presentations and has been awarded with 1 international and 6 national awards on the academic platform.

He also has several professional affiliations or memberships to his name and they are given as follows:

1. Life member of Indian Epilepsy Society
2. Associate member of Neurological Society of India
3. Life member of Neurosurgical society of India
4. Life member of Trauma Society of India
5. Associate member of Skull base Society of India

He has performed 120 Epilepsy surgeries in the past 5 years in addition to 100 Spine and tumor related procedures.

Early childhood and schooling
Born on 16th July 1981, Doctor Nilesh Kurwale was brought up in a small village near Yavatmal of Vidarbha region in Maharashtra. He completed his primary and secondary education there and was always a bright student. This is evident from the fact that he stood first in school in his 10th class board examinations and then moved on to find success during further education as well.

Dr. Nilesh pursued his early medical studies from Government Medical College, Nagpur, which is known to be one of the best colleges in central India. But this was not enough and he completed his residency in Neurosurgery at All India Institute of Medical Sciences, New Delhi, which is a Premier medical college of India. AIIMS has largest neurosurgical case volume, operating more than 6000 cases, with all subspecialties practices at world-class level. He also got his fellowship in Epilepsy surgery from AIIMS.

Dr. Kurwale has always been a grateful and humble person and this reflects in the way he talks about his mentors. He learned Neurosurgery from various mentors and faculty members at AIIMS but in particular Dr. B S Sharma, Dr. Sarat Chandra and Dr. Ashish Suri were the mentors who helped him understand the importance of dedication that is needed to acquire expert skills and perseverance needed to practice Neurosurgery. During this education, he was motivated and encouraged to practice many hours in the animal laboratory after duty hours to master the finer skills before doing it on patients. The animal laboratory was a privilege available at AIIMS. This further imbibed in him the character that truly shapes anyone who is in the field of medicine.

Inspiration and interests
It is a known fact that we are always inclined and attracted to the things that we see or observe during our childhood. The same was the case with Dr. Kurwale. He grew up watching his maternal uncle who had uncontrolled epilepsy. He used to have multiple seizures every week and used to have falls, injuries, and scars all over his face. It used to be a pitiable situation for his primary caregivers. This is why, while doing Neurosurgery, he was attracted to epilepsy surgery. However before Dr. Nilesh finished the epilepsy surgery fellowship, his uncle expired in one of the attacks of epilepsy. Due to this, he believes and thinks that surgery would have helped him live much better life and could have made a huge difference.

Besides professional life, Dr. Nilesh takes interest in many other activities in life. He has a keen interest in sports and is involved himself in running, long-distance cycling, mountaineering and playing badminton.

Life goals
Dr. Nilesh Kurwale strongly believes that he became a doctor by serendipity and found profound interests in patient care and taking challenging tasks in the healthcare field. According to him, Epilepsy surgery is a highly neglected area in healthcare which has a huge impact on patient’s quality of life. In pediatric age group, surgery has a potential to change the path of someone’s life.

He says that he and his team of doctors are working with a goal to create community-level awareness about epilepsy surgeries. Through their constant efforts, they are also training more people and establishing more epilepsy surgery centers to reduce the treatment gap in the field of epilepsy, particularly in India.

His main aim is to glorify epilepsy surgeries so that more and more physicians are sensitized towards it and would be interested to make it a career. Only an empathetic person like Dr. Kurwale can think of truly bringing about a change in the field of medicine to support epilepsy. Kudos!

Case Study 1
Treating a 9 month old infant for Epilepsy ensuring that child is back on his development.

A Nine-year-old infant from Jaipur was refereed to Dr. Nilesh Kurwale for evaluation. He was one of the twins born at a hospital without any perinatal events, cried well and was all right till the third day of life when he started having seizures. He was put on antiepileptic drugs and controlled for one month but seizures started again and he was tried on multiple antiepileptic medications. The fourth month onwards he used to have continuous seizures all through with 10 minutes interval of normalcy in between, a condition we call as status epilepticus, meaning continuous epilepsy. His mother used to feed him in between seizures and hence his weight at nine months was just 4.5 kg. His brain development has halted at three months and he was not even able to hold the neck. He was in a terrible situation when he came to us.

Dr. Nilesh Kuwale’s team did video EEG and proved that all his seizures are coming from the right hemisphere. MRI of the patient showed a condition called hemimegalencephaly where one complete hemisphere of the brain was grown abnormally and does not have any useful function, but only produces seizures. Here major surgical challenges were low weight, poor nutrition and complex nature of the surgery. The maximum allowable blood loss was just 50 ml. Operative complications are very high in such patients, which includes a life risk as well. The medical team discussed all the issues with parents and took their consent. Parents readily agreed as they were experiencing the tragic life the kid was going through and surgery was the only ray of hope for them

The kid was taken for a surgery called functional hemispherotomy, where doctor disconnects the abnormal hemisphere from rest of the brain. Surgery went smooth but lasted for 10 long hours and the team could manage it within blood loss of 60 ml. The patient was put on a ventilator after surgery and shifted to ICU. Next day, kid woke up fine without any seizures and was doing well hence taken out of ventilator. He had uneventful stay at the hospital and discharged on day 10 of surgery after stitch removal.

Patient follow-up at 3 months showed that now he has very brief 1 -2 seizures a day but he has gained significant weight and started developing neck control, social smile and tries to follow objects. He is still lagging in development but he is now gaining it. His brief seizures may stop on its own or we need to do some small revision surgery on him once he is little better.

Epilepsy surgery can be considered as early as possible so as to preserve the brain development. Dr. Nilesh and the team have operated on many infants and surgeries were successful.

Case Study 2
Surgery ended the misery of 22 year old patient with catastrophic drug resistant epilepsy.

A 22 year old patient came to Dr. Nilesh Kurwale in a very bad shape with daily multiple episodes of seizures for last 18 years. He had left hemiparesis but he was ambulatory and doing all his routine activities. However, he was having daily falls and had reflex epilepsy meaning even a loud sound, a tap on the shoulder or some obstacle will induce his seizure and fall. He used to have multiple injuries over face, scalp and hence bleeding and injuries were quite a routine. His parents were helpless and as he was growing in size and weight, managing him after a seizure and fall were quite a task for his parent. Even getting a medical aid was difficult. He was tried on multiple antiepileptic drugs without any benefit. He was on four antiepileptic drugs.

Dr. Nilesh’s team did video EEG and recorded many seizures in one day only, however his seizures were coming from both the occipital lobes. His MRI revealed bilateral damage of occipital lobe, right more than left. He was having falls because seizures originating in the left side of the brain were going to right side very fast and thus both the brains were shutting down simultaneously. Due to multifocality of seizures, taking out a certain part of the brain to cure his epilepsy was not an option as you cannot take out both the parts of the brain. However, his epilepsy was very bad and palliative surgery seemed an option.

The medical team suggested him palliative surgery called corpus callosotomy, wherein surgeon cuts the bridge between two cerebral hemispheres. Hence seizure originating in one hemisphere will not go to other hemispheres thus preventing simultaneous stopping of both the hemispheres and fall. The patient underwent uneventful corpus callosotomy, spent 10 days in the hospital and got a discharge. He is much better after this surgery.

In last six months after surgery, the patient did not have a single fall and did not sustain any injury and overall seizure frequency went down by 80%. He continues to do his daily activities however with much more confidence. Now he goes to garden and nearby places all alone. His parents are very happy and became ambassadors of epilepsy surgeries sending more than 5 resistant epilepsy patients from their region in last six months.

Discalimer: The information provided in this feature is for general information purpose only. Team at DrStories.com does not guarantee its correctness nor should it be used for any health/medical related decisions.

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