What You Need To Know About Epilepsy Surgery

Epilepsy surgery is a type of surgery where areas of the brain are removed, disconnected, or stimulated by a neurosurgeon. These changes to the brain can stop or reduce the frequency or intensity of seizure activity. The type of surgery that is recommended depends on the type of seizures, location of seizures and any brain abnormality.  

Individuals that can benefit from epilepsy surgery are people who continue to have seizure activity after trying multiple anticonvulsant medications, dietary changes, devices or other therapies. To be evaluated for epilepsy surgery, you might need the following tests or consults:  

• EEG
• Brain imaging
• Neuropsychological evaluation 
• Psychological evaluation 
• Physical medicine and rehabilitation consultation 
• Neurosurgery 
• Invasive EEG Monitoring 

There are four types of epilepsy surgery, including:  

• Corpus Callosotomy: Nerve fibers connecting the two halves of the brain are cut, interrupting the seizure.  
• Hemispherectomy: The half of the brain that is causing seizures is either totally or partly removed or disconnected from the rest of the brain.  
• Resective Surgery-Lobectomy/Lesionectomy: The brain has several areas known as lobes — the temporal,frontal, parietal and occipital lobes — and seizures may start in any of these areas. A lobectomy is an operation to remove part or all of a lobe. A lesionectomy is to remove isolated lesions, or irregularities, such as tumors or congenital malformations in the brain that have been identified as the cause of seizures. 
• Vagal Nerve Stimulator (VNS) Insertion: VNS is a surgically implanted device like a pacemaker that helps reduce the number or length of seizures. The device delivers an electrical current to the vagus nerve, located in the neck. The nerve then sends the current to the brain. 

It is important to know that a person may still have seizure activity after epilepsy surgery. Please continue to follow seizure safety after surgery.  

It is normal to be uncomfortable right after surgery, but pain medication helps to minimize the discomfort. Nurses will administer this medication only when you ask for it to prevent over‑sedation. Ice may be applied for short periods to decrease swelling and help control discomfort. Swelling along the incision line is common. 

Sleeping with your head elevated on several pillows and being as active as possible during the day will minimize the swelling. 

After surgery, you will need to continue anticonvulsant medication. If you remain seizure‑free over an extended period, your neurologist may gradually reduce or even eliminate anticonvulsants, although this is rare. It is important to note isolated seizures may occur immediately following surgery. Make sure that you stay in contact with your neurology provider so they can monitor seizure activity and anticonvulsant medications. 

Please contact your neurosurgery or neurology provider if concerns arise after discharge from the hospital.  

Your neurology provider can discuss your epilepsy management plan with you before and after epilepsy surgery. 

If your child experiences seizures or has epilepsy, we offer complete diagnostic services and a team of experts to provide comprehensive care, beginning with a first seizure evaluation by experts in nursing and neurology (pediatric neurologists, epileptologists, and neurology nurse practitioners).

As your child grows into their teen years and adulthood, we’ll continue to work closely with your family to provide the most effective management and best care for epilepsy and seizures. Over the course of treatment, your child might receive care from providers in the following specialties and services:

• Chaplaincy
• Child life
• Endocrinology
• Medical genetics and genetic counseling
• Neurodevelopmental pediatrics
• Neurodiagnostics for tests such as EEGs, VEEGs and overnight sleep studies
• Neuropsychology
• Neurosurgery
• Nutrition and feeding
• Pediatrics and general medicine
• Psychology
• Radiology and imaging
• Rehabilitation medicine
• Rehabilitation therapies, including occupational, physical, and speech and language therapy
• Sleep medicine
• Social work
• Therapeutic recreation

You can trust your child’s care to our expertise in treatment of epilepsy and seizures. As a regional leader in pediatric neurology and neurosurgery, we understand that many kids who have epilepsy also have complex associated conditions, such as cerebral palsy, developmental delays or traumatic brain injuries. That’s why we offer a large team of specialists and extensive support services.