Epilepsy refers to a group of related neurological disorders that cause seizures. In certain cases of epilepsy non-surgical treatment methods such as medicinal drugs fail to treat it and these require a surgery.
Epilepsy surgery is actually a form of neurological (brain) surgical procedure to treat the seizures that are a characteristic of epilepsy. Epilepsy surgery helps to control the seizures and resultantly improve your quality of life remarkably.
An epilepsy surgery is considered only in such cases where the specific region of the brain that is the starting point of the seizures can be identified clearly. The area to be removed should not be in a vital part of the brain which might affect your critical functions such as movement, sensation and language. A thorough diagnosis and evaluation will be performed to determine if surgery is an appropriate choice in your case.
Types of Epilepsy Surgeries
The first type of surgery mainly deals with resection (removal) of certain areas of the brain that are the cause for seizures.
The second type of epilepsy surgery aims to disturb the neural pathways that are channels for seizure impulses to spread within the brain.
The third type of surgery is required in very rare and severe cases of epilepsy where an artificial device needs to be implanted which is used to treat epilepsy.
Am I a candidate for Epilepsy Surgery?
Surgery is an option for people who are epileptic and the non-surgical methods to control it have been unsuccessful or when the side effects of the medicinal drugs are severe and affect your normal life.
Epilepsy surgery is not recommended for people suffering from serious medical disorders such as heart disease or cancer.
What types of Epilepsy Surgeries are there?
There are a few different surgeries available to treat epilepsy. The type of seizures and the specific location of the seizure focus decide the kind of epilepsy surgery that may be required.
These are the types of epilepsy surgery treatments:
The brain is basically divided into four quarters that are paired with the opposite one and each quarter is called a ‘lobe’. The four lobes of the brain (cerebrum) are: frontal, parietal, occipital and temporal.
Epilepsy of the temporal lobe is the most common type of epilepsy and has the seizure focus located in the temporal lobe. Temporal epilepsy is most commonly seen in teenagers and adults. In a lobe resection the brain tissue in the lobe is removed so the seizure focus is resected. At times a lobe resection may be required in any of the neighboring lobe as well.
This is a surgical procedure to take out individual brain lesions which are regions that are damaged due to an injury, tumor or a deformed blood vessel that may be causing seizures. Seizures are known to stop immediately after a lesion is removed.
The two hemispheres (halves) of the brain are connected with a band of nerve fibers known as the corpus callosum. At times certain nerves in the band may become channels for spread of the seizure activation signals in the brain and needs to be cut partially or completely in order to control the spread of seizure signals from the hemispheres in the brain. This surgery is ideally suggested for people with extreme forms of epilepsy that is uncontrollable and can lead to serious injuries to them. This surgery is also known as the ‘split-brain’ surgery.
A functional hemispherectomy is a surgical procedure that involves disconnecting one hemisphere from the other parts of the brain as well as removing a limited amount of brain tissue. This surgery is usually suggested for children younger than 13 years of age.
Multiple Subpial Transection (MSP)
This type of epilepsy surgery is useful in helping to control seizures that have their seizure focus in areas of the brain that are vital and cannot be removed. The MST procedure requires making shallow incisions in the brain tissue to disrupt the movement of seizure impulses from spreading in the brain.
Responsive Neuro-stimulation (RNS) Device
This is an artificial device which is implanted in the brain to control seizure activity. The device consists of a small brain stimulator that needs to be implanted within the skull just under the skin of the scalp. This device is connected to wires that are fixed to suspected seizure focus regions. The device is helpful in detecting abnormal neural activity in that area and send electrical stimulation to normalize brain activity before the seizure begins.
Are there any risks of Epilepsy Surgery?
There are certain risks involved in an epilepsy surgery, such as:
Surgery-associated – Infection and bleeding as well as anesthetic allergy reaction are the risks associated with surgery.
Neurological Deficits – Surgery may increase present problems or give rise to new ones such as affected vision, speech, movement or memory if it affects the brain functions.