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Types of Brain Surgery for Epilepsy

Overview

Highlights

  1. If you have epilepsy and can’t control your seizures with medications, your doctor may recommend brain surgery.
  2. Brain surgery may help reduce the number or severity of your seizures.
  3. Brain surgery involves serious risks and a long recovery process.

Your doctor may recommend brain surgery to treat epilepsy if you have seizures that medications can’t control. You must have tried two or more medications without success to qualify. Brain surgery for epilepsy has a high success rate. It may significantly improve your quality of life.

Epilepsy can vary greatly from one person to another. 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

Resective surgery is the most common type of surgery for treating epilepsy. If you have epilepsy, your doctor can use MRI to learn where seizures occur in your brain. Using resective surgery, they can surgically remove the part of your brain where seizures happen. They’ll likely remove an area roughly the size of a golf ball. They may also remove a brain lesion, a brain lobe, or a portion of a brain lobe.

The most common type of resective surgery is a temporal lobectomy. It’s the most successful form of surgery for epilepsy. It may reduce the number of seizures you have while limiting your risk of permanent brain damage.

Multiple subpial transection

A multiple subpial transection is a rare procedure. Surgeons only perform this surgery on people who have severe and frequent seizures. It involves cutting parts of your brain to prevent the spread of seizures. It may be more effective than resective surgery if your seizures don’t always start in the same part of your brain. Your doctor may also recommend it if your surgeon can’t remove a small part of your brain because of its vitality.

Hemispherectomy

The Mayo Clinic describes hemispherectomy as “the most radical type of epilepsy surgery.” In this procedure, a surgeon removes the outer layer of one entire side of your brain. It’s used when an entire side of your brain is damaged from seizures. The most common candidates for this type of surgery are younger children, babies born with brain damage, and older children with severe seizures.

The earlier in life you have this surgery, the better your long-term outcome will be.

Corpus callosotomy

Corpus callosotomy is different from other types of brain surgery for epilepsy because it can’t stop your seizures. Instead, its purpose is to decrease the severity of your seizures. By cutting the nerve fibers between the two sides of your brain, your surgeon can help stop seizures from spreading from one hemisphere to the other. By stopping the spread of seizures throughout your brain, they can help make your seizures less severe.

Corpus callosotomy is most often used in children who’ve bad seizures that start in one half of their brain and spread to the other.

Risks of brain surgery

Brain surgery offers potential benefits that may improve your quality of life, but it also involves serious risks. The risks may include:

  • infection
  • stroke
  • paralysis
  • speech problems
  • loss of vision
  • loss of motor skills
  • more seizures

Different types of brain surgery involve different risks. A hemispherectomy can affect your vision and movement. Removal of a specific lobe can cause speech and memory issues. Some people who choose corpus callosotomy experience more seizures after surgery. It’s important to weigh the potential benefits and risks with your doctor.

What to expect after surgery

Brain surgery is a major procedure that requires adequate recovery. If you have brain surgery, you shouldn’t plan on participating in normal activities for several weeks afterward. You’ll need to work your way up to regular levels of physical activity.

The recovery time for brain surgery can be long. According to the Mayo Clinic, most patients experience:

  • a hospital stay lasting three to four days after surgery
  • severe pain for a few days after surgery
  • moderate pain and swelling for several weeks
  • time off school or work for up to three months

You may need to continue taking antiseizure medications for at least a couple of years after your surgery.

Despite the lengthy recovery time, brain surgery can be worth it for people with epilepsy. Talk to your doctor if you think you might be a good candidate. They can help you understand the potential benefits and risks of surgery, as well as your long-term outlook.

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