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    What Is Epilepsy Surgery?

    What Are the Options? continued...

    Functional hemispherectomy. In a hemispherectomy, the doctor removes an entire hemisphere -- or half of your brain. In a functional hemispherectomy, the doctor leaves the hemisphere in place but disconnects it from the rest of your brain. He only removes a limited area of brain tissue. This surgery is mostly for children younger than 13 who have one hemisphere that doesn’t work the way it should.

    Multiple subpial transection (MST). This procedure can help control seizures that begin in areas of your brain that can’t be safely removed. The surgeon makes a series of shallow cuts (he’ll call them transections) in your brain tissue. These cuts interrupt the flow of seizure impulses but don’t disturb normal brain activity. That leaves your abilities intact.

    Vagus nerve stimulation (VNS).  A device put under your skin sends an electronic jolt to the vagus nerve, which controls activity between your brain and major internal organs. It lowers seizure activity in some people with partial seizures.

    Responsive neurostimulation device (RNS). Doctors put a small neurostimulator in your skull, just under your scalp. They link it to one or two wires (called electrodes) that they place either in the part of your brain where the seizures start or on your brain’s surface. The device detects abnormal electrical activity in the area and sends an electric current. It can stop the process that leads to a seizure.

    How Well Does It Work?

    It depends on the type of surgery. Some people are completely free of seizures after surgery. Others still have seizures, but less often. You’ll need to keep taking anti-seizure medication for a year or more afterward. Once your doctor knows your seizures are under control, you may be able to cut back on meds or stop taking them.

    Are There Risks?

    Before you have surgery, your doctor will discuss the pros and cons with you. Some risks are:

    • Infection and bleeding, as well as the chance of an allergic reaction to the anesthesia. These are common with any operation.
    • Making existing problems worse or creating new trouble with the way your brain works. You could lose vision, speech, memory, or movement.
    • A return of seizures.

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