Neurosurgery for Epilepsy
People often think of neurosurgery only in the context of tumor removal. However, there are actually several reasons why a patient may need neurosurgery. Neurosurgeons address issues across the entire nervous system rather than solely the brain. This means they are trained to treat spine, neck and brain disorders.
Epilepsy is one of the main reasons that patients seek neurosurgery. Typically, neurosurgery is only recommended after several medications have failed to resolve the seizures. Some of these procedures have been around for decades, but as scientists have gained knowledge about the specialized functions of regions and developed technology to see the seizures as they are happening, the surgeries have become more precise. Consequently, there are several types of procedures available. It is important to realize that not all neurosurgeries will cure the seizures entirely. In these cases the goal is to significantly reduce the number of seizures in order to achieve greater quality of life.
Resective, or ablative, surgery is one type of surgery that may be used to treat epilepsy by removing part of the brain itself. This surgery will be utilized if preliminary testing determined that the seizures are localized to a specific region. They will proceed if the region can be removed with little complications to functionality or personality. These surgeries are the most effective in treating epilepsy, as they often cure rather than just reduce the seizure activity.
One of the most common and successful types of resective surgery is temporal lobectomy. Many people experience seizures that center from the anterior portion of the temporal lobe. If the surgery is being performed on the left side, where language processes occur, the surgeon will likely wake the patient during the procedure in order to test the patient’s linguistic function. Typically, hospitalization is less than one week long.
Disconnection, or augmentative, surgery is a procedure that prevents the seizure-afflicted area from communicating with other areas of the brain. This type of surgery rarely is a cure, but does reduce seizures and restore functionality. It is also the only choice when the affected area is vital and can’t be removed. A common type of disconnection surgery is a corpus callosotomy, in which the corpus callosum that connects the two hemispheres is severed but not removed. This is used for patients who experience excessive generalized seizures. This will limit the seizures to the hemisphere of their origination.