Types of Epilepsy Brain Surgery

Written by Kristeen Cherney | Published on July 10, 2014
Medically Reviewed by George T. Krucik, MD, MBA on July 10, 2014

Overview

Epilepsy brain surgery becomes an option when medications aren’t effective in preventing seizures. You must have tried two or more medications without any success to qualify. While this type of surgery sounds frightening, it has a high success rate and can significantly improve quality of life with epilepsy. Epilepsy varies greatly from person to person, so there are numerous types of surgery.   

Partial Brain Surgery

Doctors can determine where seizures occur in the brain using magnetic resonance imaging (MRI). The most common type of epilepsy surgery is removing the part of the brain where seizures happen. Also called resective surgery, this procedure removes an area roughly equivalent to the size of a golf ball. This is also sometimes referred to as a seizure focus removal.

In partial brain surgery a doctor might remove a:

  • lesion
  • lobe
  • portion of the lobe

Partial brain removal is the most successful form of epilepsy surgery. It’s aimed at reducing the occurrence of seizures while limiting the risk of permanent brain damage.

Multiple Subpial Transection

A multiple subpial transection is only used for patients experiencing severe and frequent seizures. This is a rare procedure that involves cutting parts of the brain to prevent the spread of seizures throughout the brain. It may be more effective than partial brain surgery for people whose seizures don’t always start in the same part of the brain. It’s also preferred if a surgeon can’t remove a small part of the brain due to its vitality. Like partial removal, a multiple subpial transection may help patients retain normal motor skills and other abilities.

Hemispherectomy

A more serious surgery is a hemispherectomy. The Mayo Clinic describes this procedure as: “the most radical type of epilepsy surgery.” A hemispherectomy removes the outer layer from one entire side (hemisphere) of the brain. This procedure is used in cases where the entire side of the brain is damaged from seizures. The most common candidates are:

  • younger children
  • infants born with brain damage
  • older children with severe seizures

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

Corpus Callosotomy

A corpus callosotomy is different from other types of epilepsy brain surgeries because it can’t stop seizures. The purpose of this procedure is to decrease the severity of the seizures. By cutting nerve fibers between the two sides of the brain, it prevents seizures from spreading from one hemisphere to the other. By stopping the spread of seizures throughout the brain, the seizures themselves may be less severe.

Corpus callosotomies are most often used in children who have bad seizures that start in one half of the brain and then spread to the other.

Risks of Epilepsy Brain Surgery

As with any type of surgery, epilepsy brain surgery is a serious procedure. There are certainly potential benefits, but you must also outweigh the risks with your doctor. Risks may include:

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

The type of brain surgery can dictate the number of potential risks. Hemispherectomies can affect vision and movement, while specific lobe removals can cause speech issues. Some people who choose corpus callosotomy experience more seizures after surgery.

What to Expect After Surgery

Brain surgery is a major procedure that requires adequate recovery. You should not plan on participating in normal activities for several weeks. You will need to gradually work your way up to physical activity.

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

  • brain surgery lasts for four hours or longer
  • three- to four- day stay in the hospital
  • no school or work for up to three months
  • severe pain for a few days after surgery
  • moderate pain and swelling for several weeks

Despite the lengthy recovery time, brain surgery can be worth it for people with epilepsy. You still need to take anti-seizure drugs medications for a couple of years after surgery. Talk to your doctor if you think you might be a good candidate for epilepsy brain surgery.

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