Even though medicine is the most common
approach to treating epilepsy, it does not always work. In almost one-third of
people with epilepsy, medicine cannot control their seizures adequately (or at
all, in some cases). This number is even higher in
focal epilepsy. Surgery can greatly improve the lives
of some people who have
You may be a good candidate
for surgery if your seizures:
On the NBC show Heroes, Greg Grunberg plays an ordinary guy with
extraordinary powers. In real life, he credits astonishing powers to his
13-year-old son, Jake, who has lived with epilepsy for the past five years.
Epilepsy, a neurological condition that affects 3 million Americans (350,000
of them are children), causes periodic seizures, where the brain produces a
sudden burst of electrical activity. During a seizure, people can shake, stare,
fall down, or even briefly lose consciousness. "To...
Tend to result in injury or harm (for instance, if seizures
cause frequent falls).
Change or alter your
Are not controlled well with medicine, or you cannot
tolerate the side effects of the medicines.
Having frequent or severe seizures often restricts you from
driving, doing certain kinds of work, and other
activities. Medicine may fail to control these seizures. Or medicine may cause side
effects severe enough to disrupt your lifestyle.
Surgery is not an
"if all else fails" approach to treating epilepsy. It often may be a better
choice than trying each and every medicine. For
temporal lobe epilepsy, for instance, surgery may be
considered if two different first-line medicines are tried and neither controls
the seizures adequately. For certain types of childhood epilepsy-disorders
that children cannot outgrow and that do not respond to medicine-having surgery
at the youngest possible age may offer the greatest benefit for the child. The
younger brain is more adaptable and recovers better after surgery.
Epilepsy surgery removes an area of abnormal tissue in the brain, such as
a tumor or scar tissue, or the specific area of brain tissue where seizures
begin. Before surgery, you may have several tests (including an
magnetic resonance imaging [MRI], and video
monitoring) to find exactly where seizures begin in the brain. After the
area of abnormal tissue where your seizures begin has been located, doctors can
decide whether or not it can be removed safely.
usually done in a hospital that is associated with an epilepsy center. The
surgery usually takes a few hours, and you have to stay in the hospital for a
few days afterward. It may be several months or more before you feel fully back
The type of epilepsy surgery depends on the location in
the brain in which seizures start.
The most common surgery is
anterior temporal lobectomy, which is the removal of
part of one of the brain's temporal lobes. For many people with temporal lobe
epilepsy, this surgery offers a very good chance of becoming
Some types of surgery are usually only done on
Surgery can be very effective
for some people with epilepsy. But surgery is not an option for everyone. If you or
your child has a type of epilepsy that might improve with surgical treatment,
you may want to think about some of these issues:
Surgery is not a last resort. It may be
considered after unsuccessfully trying two medicines.
surgery for some forms of childhood epilepsy may end seizures and prevent or
reverse developmental delays. Children make good surgical candidates. They tend to recover quickly with fewer problems
People who have temporal lobe epilepsy and whose seizures do
not get better with medicines may be good candidates for
Surgery is not always a cure for epilepsy. Some people
never have seizures again after surgery. But for many others, surgery only
reduces seizure frequency or severity.
You need to be healthy to
have the surgery and to benefit from it. People with severe illnesses,
psychiatric disorders, or neurological problems other than epilepsy may need
evaluations from more specialists to see if they are good candidates for
Epilepsy surgery involves removing part of your
brain. It can affect your brain function, although the effects may be less
bothersome than those caused by the epilepsy itself. Problems after surgery can
be mild to severe-such as less energy, visual defects, language and memory
problems, and weakness or partial paralysis on one side of the body-and may be
temporary or permanent.
Brain surgery is an expensive way to treat
epilepsy and carries with it many risks. Even if medicine does not prevent your
seizures, surgery may not be recommended if you only have seizures once in a
while or do not have severe seizures.