Why Epilepsy Surgery Has Become More Advanced

Remarkable advances in diagnosing and treating epilepsy have been made in recent years. Today, surgery has become a treatment option for many adults and children with medically intractable epilepsy — the 30 percent of epilepsy patients for whom drug therapy is either ineffective or produces intolerable side effects.

Advances include:

  • A growing number of subspecialty-trained physicians
  • Improved anesthetic agents
  • Intraoperative monitoring
  • Innovative surgical techniques, such as awake craniotomy

How Epilepsy Surgery Eliminates Seizures for Most People

The success of epilepsy surgery is measured in terms of the operation’s impact on seizure control and improvement in quality of life. Successful surgery eliminates seizures in the majority of cases. In a minority of cases, seizure frequency is markedly reduced.

Ten years after epilepsy surgery, 68 percent of Cleveland Clinic patients who have undergone temporal lobe resection (removal of tissue) — the most common type of epilepsy surgery — continue to be seizure-free.

Significant improvement in lifestyle and social interactions also may occur.

For some patients, anticonvulsant medications may be reduced or discontinued by a neurologist following a thorough evaluation of seizure status one to three years after surgery. Some patients may continue to experience auras (warning signs and sensations) and require long-term maintenance medication(s) in order to achieve complete seizure control.

Are You a Candidate for Surgery?

If anticonvulsant medications have failed to control your epilepsy, or you are experiencing intolerable side effects from anticonvulsants, you may be a candidate for epilepsy surgery. Please ask your doctor if surgery is an option for you.

The process to decide whether you are a candidate for surgery involves:

  1. A thorough medical history
  2. Physical examination, including brain wave monitoring and other tests

The goal is to identify a specific source of the seizures in your brain that can be safely removed without affecting important brain-controlled functions.

Surgery Questionnaire

  1. Do you suffer from seizures that are not stopped by medicines?
  2. Have you been told you have epilepsy?
  3. Have you been told there is something abnormal on a CAT scan or MRI of your brain?
  4. Do you take more than one medicine to stop seizures?
  5. Did you have a seizure with a high fever as a child?

If you answered yes to any of these questions, you may be a candidate for epilepsy surgery. Please contact us at 216.444.9058 so that we may get more information and arrange a consultation.

If Surgery Is Not an Option

In some cases, surgery is not possible. Seizures may come from multiple brain areas, or the risk on brain function may be too high. In these situations, other options are available. New treatments for epilepsy are continually being developed and it may be possible to participate in an experimental trial of a new drug or other therapy.

One therapy for patients when resective surgery is not possible is the Vagus Nerve Stimulator (VNS). This is an FDA-approved treatment for epilepsy. VNS involves minor surgery to implant a pacemaker to stimulate the vagus nerve in the neck. Ask your doctor about this and other alternative treatments.

Reviewed by a Cleveland Clinic medical professional.

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