If you have epilepsy that cannot be controlled by medication (drug-resistant epilepsy), brain surgery may be something to consider. Brain surgeries for epilepsy, often referred to as epilepsy surgeries, can make seizures less severe or even completely eliminate them. Here are some types of brain surgeries that are done to treat epilepsy.
Resective surgery
Resective surgery is the most common type of brain surgery done for epilepsy. In resective surgery, the surgeon removes a small section of the brain from the area that causes seizures–usually the temporal lobe. This type of surgery is generally effective, with over 70% of epilepsy patients achieving seizure-free status after the procedure.
Laser interstitial thermal therapy (LITT)
Laser interstitial thermal therapy, or LITT, involves a surgeon using a laser to target and remove a part of the patient’s brain tissue. The surgeon uses magnetic response imaging (MRI) as a guide to determine what area of the brain to operate on. This technique is less invasive than resective surgery.
Deep brain stimulation (DBS)
In deep brain stimulation, a surgeon will implant an electrode inside the brain in order to control seizures. The electrode is connected to a device implanted inside the chest called a neurotransmitter through a wire. The electrode periodically sends signals to the brain to stop seizures from happening.
Corpus callosotomy
Corpus callosotomy is a surgery in which the nerves connecting the two sides of the brain (called the corpus callosum) are cut. The purpose of this procedure is not to stop seizures entirely, but to decrease the severity of them. By cutting the nerves linking both halves of the brain, the seizures cannot move from one side of the brain to the other. Corpus callosotomy is usually done in children who suffer from epilepsy.
Hemispherectomy
A hemispherectomy is done exclusively in children with severe epilepsy whose seizures originate on one side of the brain. During the procedure, a surgeon will remove or disconnect part of the brain on one side, as well as cut the corpus callosum to prevent seizures from moving to the other side of the brain.
Functional hemispherectomy
This method of epilepsy surgery is also done in children, and unlike a hemispherectomy, does not involve removal of brain tissue. Instead, a surgeon will just cut the corpus callosum to prevent seizures from spreading between both halves of the brain.
Risks of epilepsy surgery
All of the aforementioned surgeries involve risks, however. Less invasive techniques like laser interstitial thermal therapy and deep brain stimulation are considered to be safer than procedures like resective surgery, but may also carry risks. Some risks of epilepsy surgeries include:
- Bleeding in the brain
- Infection
- Tissue injury
- Depression
- Stroke
- Problems with language and/or memory
Making the decision to undergo brain surgery is never easy. But although the surgery can result in complications, epilepsy that isn’t managed properly can be much more of a health risk. Thus, brain surgery for epilepsy is recommended, and may even be encouraged, when medication does not do its job. In order to determine which type of surgery is right for you, discuss the matter with your doctor.
When the time comes to decide on the procedure, choosing a qualified surgeon can ensure peace of mind, and when the operation is over, a healthy life free of seizures.
Written by Natan Rosenfeld