Epilepsy Surgery

What is epilepsy surgery?

An epilepsy surgery is an operation to the brain which, depending on the type of surgery, may consist of:

  • Removing the area of the brain that causes seizures
  • Disrupting nervous pathways that seizure impulses take
  • Implanting a device to treat epilepsy

Types of epilepsy surgery

There are many types of epilepsy surgery. They target different parts of the brain depending on the location of the neurons that are causing seizures.

Your doctor will also consider your age before recommending the most suitable type of epilepsy surgery to address your condition.

  • Resective surgery, where a small portion of the brain is removed. Your surgeon will cut out brain tissues from the area of the brain where seizures happen. This is usually the site of a tumour, brain injury or malformation. The awake craniotomy technique is often used for resective surgery.
  • Temporal lobe resection, also known as temporal lobectomy, removes part of the brain's temporal lobe. It is the most common type of epilepsy surgery.
  • Deep brain stimulation involves implanting a device permanently inside your brain. This device will release electrical signals to disrupt abnormal, seizure-inducing activity. A generator used to send the electrical pulses will also be implanted in your chest.
  • Corpus callosotomy removes part of the brain that connects nerves on the right and left hemispheres of your brain. This part is called the corpus callosum. This surgery helps patients with abnormal brain activity that spreads from one side of the brain to the other.
  • Hemispherectomy removes one hemisphere of the cerebal cortex. This is usually done in children with severe seizures.
  • Functional hemispherectomy removes the connection nerves in the corpus callosum without removing actual pieces of the brain.

Why do you need an epilepsy surgery?

Epilepsy surgery may be an option when medications do not control your seizures.

Resective surgery is only an option if:

  • Your doctor can clearly identify the area of the brain where seizures start
  • The area to be removed doesn't control critical functions such as language, sensation or movement

Severe epilepsy can result in complications and health risks, such as the following:

  • Physical injuries during a seizure
  • Drowning, if a seizure happens during a bath or a swim
  • Depression and anxiety
  • Developmental delays in children
  • Worsening memory and cognitive ability
  • Sudden death

The expected outcome of most epilepsy surgeries is to be able to control seizures with medication.

Who should not undergo epilepsy surgery?

You should not undergo epilepsy surgery if you have serious medical problems such as active cancer or heart failure.

What are the risks and complications of epilepsy surgery?

Other than the general risks of surgery, epilepsy surgery also carry the following risks:

  • Infection and bleeding
  • Cognitive impairment, such as:
    • Memory and speech problems
    • Loss of vision
    • Loss of ability to coordinate movement
  • A return of seizures
  • Depression or other mood changes
  • Headaches
  • Stroke

The degree of risk depends on the type of surgery and the extent of your condition. Your doctor will explain to you the specific risks of your procedure and how they plan to reduce the risk of complications.

This page has been reviewed by our medical content reviewers.

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