Surgery for Epilepsy

Epilepsy Information 2012

Surgery for Epilepsy

Surgery for epilepsy is a medical procedure that is performed in hopes of curing or improving a serious epilepsy problem. It should be mentioned that this procedure does not work for all types of epilepsy and is only done in cases where the condition can no longer be managed by ordinary medication. In essence, it is often considered as a last resort owing to the complexities associated with brain surgery as well as the potential complications that may arise following the procedure.

A primary precondition for surgery for epilepsy is that the area where seizures are originating from has to be definitively identified. This is often difficult to do because for doctors to be able pinpoint the exact location of where the seizures are coming from, the patient has to be hooked to an EEG device during the time a seizure occurs. A second precondition also requires that the patient has tried multiple drugs to treat the condition; only if these drugs fail will surgery for epilepsy be considered as a potential treatment option for the patient.

There are many types or surgery for epilepsy depending on the exact action that is being done to reduce or eliminate the seizures. Here are some of the most common:

•Removing a part of the brain. In medical parlance, this is referred to as a respective surgery. Among the most common is temporal lobe resection which is done in about 90% of epilepsy cases. A resection requires that the surgeon removes a portion of the brain about the size of the golf ball. This section corresponds to the specific part where the seizures start for the patient.

•Isolating the part of the brain causing the seizures. In this procedure, a surgeon will perform multiple cuts designed to isolate the part of the brain where the seizure is originating from. In medical parlance, this is known as multiple subpial transaction. The main goal is to ensure that the seizures do not propagate to the other portions of the brain. A multiple subpial transaction is considered when the part of the brain that causes the seizures is too important to remove.

•Cutting the connection between hemispheres. Also known as corpus callosotomy, this surgery for epilepsy is performed when it is known that the seizures are originating from one hemisphere and then propagating to the other hemisphere. This is often done when there is no specific area where the seizures come from but it is known that the initiation comes from only one hemisphere.

•Removal of half of the brain. The most invasive and extreme of all surgery for epilepsy procedures, the hemispherectomy is done mainly in children to remove the entire half of the brain where the seizures originate. A hemispherectomy is usually restricted to conditions that manifest since birth or those that appear shortly after birth.

The complications and implications associated with surgery for epilepsy are serious and form the ultimate basis for taking a cautious approach in using it as a primary treatment method for many seizure patients. Still, it is an option that remains on the table when all other options have failed. It is important to talk to your doctor to understand the full scope of implications with surgery for epilepsy so you can personally weigh the pros and cons before deciding whether or not you or a loved one agrees to undergo the operation.