Health Conditions Discover Plan Connect. Types of Brain Surgery for Epilepsy. Medically reviewed by Jeanne Morrison, Ph. Numerous types of surgery are available to treat it including: resective surgery multiple subpial transection hemispherectomy corpus callosotomy Your doctor can help you understand the potential benefits and risks of surgical options.
Resective Surgery. Multiple subpial transection. Corpus callosotomy. Risks of brain surgery. What to expect after surgery. Read this next. Temporal Lobe Epilepsy. Medically reviewed by Ricky Chen, M. Absence Epilepsy Petit Mal Seizures. Medically reviewed by Seunggu Han, M. Benign Rolandic Epilepsy Overview. Medically reviewed by Nancy Hammond, M.
Photosensitive Epilepsy Overview. Overview of Atypical Absence Seizures. Medically reviewed by Heidi Moawad, M. What Is a Febrile Seizure? Medically reviewed by Mia Armstrong, MD. Tonic-Clonic Seizure. Temporal Lobe Resection Temporal lobe resection is removing a portion of the temporal lobe of the brain. Frontal Lobe Resection Frontal lobe resection refers to removing an area in the frontal lobe where seizures begin.
The frontal lobes of the brain control functions like motivation, attention, concentration, organization, planning, mood, and impulse control.
People who have frontal lobe seizures may have problems with these functions before surgery. It is important to understand there may also be changes seen in these brain functions after surgery. Although this group continues to have seizures, the majority of people have a large decrease in the number of seizures.
A small number of people do not have any improvement in seizure control. Parietal and Occipital Lobe Resection The parietal and occipital lobes are located in the posterior back part of the brain. Lesionectomy Removing a lesion that causes focal seizures is called a lesionectomy. Multiple Subpial Transections MST Multiple subpial resections are an alternate type of surgery that is used if seizures begin in a region of the brain that cannot be removed safely.
People most appropriate for this type of surgery include People who have a clearly defined area of brain where seizures begin People who would benefit from a less invasive approach to epilepsy surgery The advantages of this therapy compared to invasive epilepsy surgery include Shorter procedure No craniotomy opening skull to access brain required Shorter hospital stay Possibly, a reduction in complications and side effects Early data on laser ablation surgery shows more than half of people treated with LITT achieve freedom from seizures.
Anatomical or Functional Hemispherectomy and Hemispherotomy These types of epilepsy surgery are almost exclusively performed in children with seizures coming from a large area on one side of the brain hemisphere. Anatomic hemispherectomy involves removing the frontal, parietal, temporal, and occipital lobes on one side of the brain. Deeper brain structures basal ganglia and thalamus are left in place.
This type of hemisphere surgery has higher risk and is usually considered for people with hemimegalencephaly a rare condition where one side of the brain is abnormally larger than the other. Functional hemispherectomy involves removing a smaller area of the affected hemisphere and disconnecting the remaining brain tissue. This surgery involves less risk but is only helpful in a select group of people.
Hemispherotomy is different than hemispherectomy as less brain tissue is removed to decrease the risk of complications from surgery. In this type of surgery, the surgeon is makes a hole or several holes in the hemisphere instead of removing large sections of the brain. Corpus Callosotomy Corpus callosotomy is usually reserved for people with severe generalized epilepsy meaning seizures involve both sides of the brain who are subject to drop attacks atonic seizures and falls.
Individuals being considered for this operation usually have Frequent tonic , atonic , atypical absence , or tonic-clonic seizures Developmental delay Disabling seizure-related falls Stereotactic Radiosurgery Stereotactic radiosurgery uses many precisely focused radiation beams to treat the area of the brain where seizures begin seizure focus. Neurostimulation Three neurostimulation devices are approved for the treatment of drug resistant epilepsy.
VNS is approved for treatment of focal epilepsy when surgery is not possible or does not work. A small electrical generator is implanted under the skin over the chest.
The generator stimulates the vagus nerve on a set schedule. Over time this helps to reduce the number and severity of seizures a person has. It is effective in over half the people who try it. RNS is a device that can record seizure activity directly from the brain and delivers stimulation to stop seizures.
The device, also called an electrical generator, is implanted in the skull. Electrodes are placed on or in the brain in the area where seizures begin. The device detects seizure onset and then delivers an electrical stimulation to stop the seizure. DBS surgery involves implanting an electrode into the brain and placing a stimulating device under the skin in the chest. The brain electrode is implanted through a small hole made in the skull. The stimulator device placed in the chest is similar to a pacemaker and is connected to the brain electrode.
The device sends signals to the brain electrode to stop signals that trigger a seizure. You may need to spend the first night after surgery in an intensive care unit.
The total hospital stay for most epilepsy surgeries is usually about three or four days. When you awaken, your head will be swollen and painful. Most people need narcotics for the pain for at least the first few days. An ice pack on your head also may help. Most postoperative swelling and pain resolve within several weeks. You'll probably not be able to return to work or school for approximately one to three months.
You should rest and relax the first few weeks after epilepsy surgery and then gradually increase your activity level. It's unlikely that you would need intensive rehabilitation as long as the surgery was completed without complications such as a stroke or loss of speech.
The outcomes of epilepsy surgery vary depending on the type of surgery performed. The expected outcome is seizure control with medication. The most common and best-understood procedure — resection of tissue in the temporal lobe — results in seizure-free outcomes for about two-thirds of people. If you remain seizure-free for at least one year, your doctor may consider discontinuing your anti-seizure medication and eventually taking you off of the drugs entirely. Most people who do experience a seizure after going off medication are able to experience seizure control by resuming drug treatment.
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This content does not have an Arabic version. Overview Epilepsy surgery is a procedure that removes an area of the brain where seizures occur. Location of temporal lobe Open pop-up dialog box Close. Location of temporal lobe The temporal lobe is located along the sides of your brain.
Brain hemispheres Open pop-up dialog box Close. Brain hemispheres Your brain is divided into two halves, called hemispheres. Request an Appointment at Mayo Clinic. Pinpointing seizure location Open pop-up dialog box Close. Share on: Facebook Twitter.
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