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:
One option for some children with epilepsy is surgery. You may be frightened by the idea of your child having brain surgery. It's definitely a treatment reserved for a select few. But while surgery for epilepsy may be a radical step, improvements have made these operations much safer and more effective.
"In the old days, doctors would wait 20 years before trying surgery in a person with epilepsy who didn't respond to medication," says William R. Turk, MD, chief of the Neurology Division at the Nemours...
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
Corpus callosotomy helps some children who have
Lennox-Gastaut syndrome by reducing falls that happen during seizures. These can happen often and often cause injury to the child.
Hemispherectomy during the first few years of life may
benefit children with other uncommon, severe forms of epilepsy (such as
Rasmussen syndrome or