Surgical Options for Treating Epilepsy

When seizures cannot be properly controlled by medications, doctors may recommend that the person be considered for surgery. Doctors generally do not recommend surgery till patients have multiple medications and sometimes other therapies without success or if there is an identifiable brain lesion – a damaged or dysfunctional area – that is causing the seizures.

Only a small number of these patients will be candidates for surgery. To decide if a person could benefit from surgery, doctors consider the type or types of seizures he or she has. They also take into account the area of the brain involved and how important that region is for everyday behavior. Surgeons usually avoid operating in areas of the brain that are necessary for speech, language, hearing or other important abilities in order to prevent these skills from being affected. Doctors may perform tests to find areas of the brain that control speech and memory. They often monitor the patient carefully before surgery in order to find the exact location in the brain where seizures begin. They also may use implanted electrodes to record brain activity from the surface of the brain. People with certain types of epilepsy are more likely to be surgery candidates than others.

Although surgery can greatly reduce or even halt seizures for some people, it is important to remember that any kind of surgery carries some amount of risk. Surgery for epilepsy does not always successfully reduce seizures and it can result in cognitive or personality changes, even in people who are excellent candidates for surgery. Patients should ask their surgeon about his or her experience with epilepsy surgery, success rates and complication rates with the procedure.

Even when surgery completely ends a person’s seizures, it is important for that person to continue taking seizure medication for some time to give the brain time to re-adapt. Doctors generally recommend medication for two years after a successful operation to avoid new seizures.

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