While surgery can significantly reduce or even halt seizures for some people, it is important to remember that any kind of surgery carries some amount of risk (usually small).
Surgery for epilepsy does not always successfully reduce seizures, and it can result in cognitive or personality changes, even in people who are excellent candidates for surgery. Patients should ask their surgeon about his or her experience, success rates, and complication rates with the procedure they are considering.
Types of surgery include:
- Lobectomy or lesionectomy
- Multiple subpial transection
- Corpus callosotomy
- Hemispherectomy and hemispherotomy
- Implanted devices
- Surgery to treat other medical conditions causing seizures (such as a brain tumor).
Lobectomy or Lesionectomy
The most common type of epilepsy surgery is removal of a seizure focus, or small area of the brain where seizures originate. This type of surgery, which doctors may refer to as a lobectomy or lesionectomy, is appropriate only for focal seizures that originate in just one area of the brain. In general, people have a better chance of becoming seizure-free after surgery if they have a small, well-defined seizure focus.
Lobectomies have a 55 to 70 percent success rate when the type of epilepsy and the seizure focus is well defined.
The most common type of lobectomy is a temporal lobe resection, which is performed for people with temporal lobe epilepsy. Temporal lobe resection leads to a significant reduction or complete cessation of seizures about 70 to 90 percent of the time.
Multiple Subpial Transection
When seizures originate in part of the brain that cannot be removed, surgeons may perform a surgery called a multiple subpial transection. In this type of surgery for epilepsy, which has been commonly performed since 1989, surgeons make a series of cuts that are designed to prevent seizures from spreading into other parts of the brain while leaving the person's normal abilities intact.
About 70 percent of patients who undergo a multiple subpial transection have satisfactory improvement in seizure control.