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Epilepsy - Is Surgery An Option?

Written and reviewed by
Dr. Naba J Borah 88% (16 ratings)
MS (Surgery), Mch (Neurosurgery)
Neurosurgeon, Guwahati  •  9 years experience
Epilepsy - Is Surgery An Option?

Living with epilepsy can be highly challenging. This is a medical condition that can be controlled with medications in most cases, but it might not be useful for all patients due to severe side effects. It is estimated that up to 30% people who have epilepsy face this issue, and in such cases, surgery might be considered as an option.

This condition typically results in seizures which is a result of sudden electrical activity in the brain. So, certain complicated epilepsy operations on the brain can help patients with their seizures and contain their symptoms.

The goal of epilepsy surgeries involves removing part of the brain that causes these seizures and disrupting parts of the nervous system in the brain that contribute to the same. The procedure also involves the installation of a device that helps control the side effects of epilepsy.

When is surgery not an option for epilepsy?
Doctors would accurately identify the part of the brain that is causing seizures as the first step. These parts are known in medical terms as the ‘seizure’ focus. This area should not be related critical functions of the brain like movement, sensation, and language involved – else surgery would not be possible.

Surgery is not viable when seizures are severe and impair bodily movement or if the patient has serious medical conditions (like cancer or heart diseases).

Common Surgery Options Available

  1. Lesionectomy: This is one of the most commonly used procedures. This form of surgery involves the surgeon removing brain lesions from the brain or areas of injury due to malformed blood vessels or tumors. These injuries can often cause seizures and epilepsy and can be treated effectively with lesionectomy.
  2. Lobe resection: This is another form of treatment which is possible only if the epilepsy is located in one of the four parts of the brain – the temporal lobe. It is quite common in younger people and can easily be treated by expert neurosurgeons by removing the brain tissues that are causing epilepsy.
  3. Multiple Subpial Transections: While the above methods involve cutting out brain tissues, sometimes such surgeries just might not be possible due to other complications. If the parts of the brain cannot be cut out, surgeons tend to adopt Multiple Subpial Transections. This procedure can help control seizures without requiring cutting out parts of the brain. Small intersections are made in the brain to disrupt the impulses from affected brain cells that cause seizures, and they do not affect normal brain activity. It helps leave all abilities intact in patients and aids in treatment very effectively.

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