Surgery for Epilepsy

Epilepsy surgery

If after trying at least two different anti-epileptic drugs (AEDs) and other treatments, such as diet, your seizures still are not under control, surgery may be considered as a treatment option. The purpose of surgery is to improve your quality of life.

Surgery can be offered to both adults and children. There are two main types of surgery:

1. Resection, removing the part of the brain where seizures start

  • Temporal lobectomy – Your surgeon will cut away brain tissue in the temporal lobes that has been causing seizures
  • Extratemporal resection – Your surgeon will cut away brain tissue in other parts of the brain that has been causing seizures
  • Lesionectomy – Your surgeon will remove any tumours, abscesses or other types of damage that have been causing seizures

2. If resection surgery isn’t possible, a type of surgery where one part of the brain is disconnected from another part may be offered:

  • Hemispherectomy – Your surgeon will remove the outer layer of one half of your brain
  • Corpus callosotomy – Your surgeon will cut the connections between the two sides of the brain, stopping seizures spreading from one side to the other
  • Multiple subpial transection – Your surgeon will cut the nerve fibers in the outer layers of the brain. This stops the seizure activity spreading.

Before you are offered surgery, you will go to a specialist centre for tests. These tests may include:

  • MRI scans
  • EEG
  • Video telemetry (an EEG while also being filmed)

Other types of scan may also be done that trace a chemical injected into your body. This can show detailed information about where seizures start in your brain.

Memory and psychological tests are also used to see how memory and lifestyle may be affected after the surgery. These tests also help the doctors to see how you are likely to cope with the impact of having this type of surgery.

The tests will confirm if:

  • The surgeons can reach the right part of the brain during surgery and can remove it safely without causing new problems
  • Other parts of the brain could be affected by the surgery, such as the parts that control speech, sight, movement or hearing
  • There’s a good chance the seizures will stop after surgery
  • There are any other medical conditions that might stop the surgery going ahead

Surgery is really a last resort if your seizures cannot be controlled and are affecting your day to day life.

The purpose of surgery is to improve the quality of your life. You do not have to have surgery and can change your mind at any point.