Description

Epilepsy surgery is a treatment option for patients whose seizures cannot be controlled with medications (drug-resistant epilepsy). The goal is to remove or disconnect the part of the brain causing seizures while preserving normal brain function. 🔹 Indications Drug-resistant focal epilepsy (seizures originate from a single brain region) Seizures causing severe disability or injury Structural abnormalities visible on MRI (cortical dysplasia, tumor, scar) Temporal lobe epilepsy with hippocampal sclerosis 🔹 Types of Epilepsy Surgery 1. Resective Surgery Anterior Temporal Lobectomy: Most common; removes seizure focus in temporal lobe. Lesionectomy: Removes a specific lesion causing seizures (tumor, cortical dysplasia). 2. Disconnection Surgery Corpus Callosotomy: Cuts fibers connecting the two hemispheres to prevent spread of seizures. Hemispherectomy / Hemispherotomy: Rare, removes or disconnects one hemisphere; used in severe unilateral epilepsy. 3. Neurostimulation / Modulation Vagus Nerve Stimulation (VNS): Implanted device stimulates vagus nerve to reduce seizures. Deep Brain Stimulation (DBS): Electrodes in thalamus modulate seizure activity. Responsive Neurostimulation (RNS): Detects abnormal electrical activity and delivers electrical pulses to stop seizures. 🔹 Pre-Surgical Evaluation MRI Brain: Identify structural lesion. Video EEG Monitoring: Localize seizure focus. PET/SPECT scans: Assess metabolic activity. Neuropsychological testing: Determine functional areas of brain. Functional MRI / Wada Test: Evaluate speech/memory dominance. 🔹 Advantages of Surgery Potential complete seizure freedom (especially temporal lobe epilepsy). Reduced need for anti-epileptic drugs. Improved quality of life, cognition, and psychosocial function. 🔹 Risks / Complications Neurological deficits (speech, motor, memory) depending on location. Infection, bleeding. Seizures may persist (not all patients become seizure-free). Psychological impact.

Filter tags