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Gurugram: Doctors at Marengo Asia Hospital in Gurugram successfully treated a 30-year-old German man suffering from refractory post-traumatic stress disorder (PTSD) and dyscognitive epilepsy through a rare keyhole surgery. Refractory PTSD, accompanied by dyscognitive epilepsy, presents a complex medical challenge, where the individual experiences intrusive memories, cognitive impairment, avoidance behaviors, and difficulty in social interactions. Dr. Himanshu Champaneri, Senior Consultant Neurosurgeon at the hospital, explained that refractory PTSD occurs when standard treatments fail, leading to a cascade of associated disorders like dyscognitive epilepsy, as seen in this case. The patient's traumatic experiences, stemming from childhood abuse, led to PTSD symptoms emerging at 17, eventually complicating into dyscognitive epilepsy, which severely impacted his daily life and professional pursuits. Champaneri explained that the coexistence of refractory PTSD and dyscognitive epilepsy presents formidable challenges in both diagnosis and treatment, as each condition can exacerbate the symptoms of the other, resulting in a complex clinical scenario. Despite seeking prior medical interventions elsewhere, which initially alleviated his symptoms, the patient's condition relapsed, leading to two suicide attempts. At Marengo Asia Hospital, the medical team employed a comprehensive approach, including revisiting traumatic memories and conducting functional MRI scans, revealing heightened activity in the right amygdala, indicative of severe refractory PTSD. The keyhole surgery, performed through stereotactic radiofrequency ablation, marked a turning point, bringing about a significant improvement in the patient's condition. Champaneri emphasized the importance of a multidisciplinary approach, involving mental health professionals, neurologists, and other specialists, to address the psychiatric and neurological aspects of the disorder. Treatment strategies encompassed a combination of medication, psychotherapy, and potential interventions such as neuromodulation or lifestyle adjustments. Following the surgery, the patient experienced profound relief, entering a state of relaxation and happiness, and regaining the ability to focus on tasks previously challenging. Remarkably, he remained free from dyscognitive seizures and experienced complete alleviation of PTSD symptoms.