Surgical Options for Epilepsy

1 What are Surgical Options for Epilepsy?

Here you can find out what are surgical options for epilepsy.

Epilepsy is a set of chronic neurological disorders characterized by seizures and the diagnosis of epilepsy implies that there is an abnormality in the brain and that this abnormality will result in more epileptic seizures.

In most people, seizures can be controlled with medications but in some cases, a surgery can be an option and there are two types of epilepsy surgery: surgery during which an area of the brain which produces seizures is removed or surgery during which the nerve pathways through which seizure impulses spread within the brain are interrupt.

Also, different surgical procedures are available and their application depends on the type of seizures and the area of the brain where the seizures start.

Types of the surgical procedures are:

  • Lesionectomy is a surgery during which isolated lesions which are responsible for seizures are removed from the brain so the seizures usually stop once the lesions are removed.
  • Lobe resection is a surgery during which brain tissue in one of the lobes (four sections of the brain – temporal, frontal, parietal and occipital) that contain a seizure focus is being resected or cut away.
  • Functional hemispherectomy is a surgery during which limited area of the brain tissue is removed and one hemisphere of the brain is disconnected from the rest of the brain so it can only be performed in children younger than 13 years old who have one hemisphere that is not functioning normally.
  • Corpus callosotomy is a surgery in which all or parts of the nerve fibers which connect the two halves (hemispheres) of the brain are cut off. It is performed only in patients with an extreme form of uncontrollable epilepsy in which seizures can lead to violent falls and potentially serious injury.
  • Multiple subpial transections is a procedure during which nerve fibers are cut with a series of shallow cuts (transections) so the movement of seizure impulses is an interrupt. It is used in vital areas of the brain that control movement, feeling, language, or memory.

A candidate for epilepsy surgery can be the person whose seizures cannot be controlled by medication or side effects of medication greatly affect the person’s quality of life. Also, the brain area where the seizures start (called the seizure focus) must be clearly identified and the area must not be responsible for any critical functions like sensation, language or movement.

The effectiveness of epilepsy surgery varies and it depends on the patient’s condition before surgery and on the type of surgery. In some patients, the seizures stop and in some patients the frequency of seizures is significantly reduced. Most patients continue taking anti-seizure medication but after seizure control is established, medications can be reduced or eliminated.

The risks of epilepsy surgery include the risk of surgery failure, the risk of neurological deficits and like in many surgeries risks associated with the use of anesthesia.

Sometimes, a re-operation (a second operation) is needed to remove brain tissue that is later found to be a source of seizure activity.

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