Epilepsy is described as drug-resistant when seizures continue despite two or more well-chosen medicines. Seizures that stay uncontrolled can affect education, work, safety and mood. For some people, surgery that removes or disconnects the area where seizures begin offers the best chance of long-term control.
Who it may help
- Seizures that continue after two or more suitable medicines
- Seizures that interfere with study, work or safe daily life
- A seizure focus that is identified on scans and EEG
- Epilepsy that began in childhood and continues into adult life
- Medicine side effects such as mood change or memory loss
Conditions treated
- Temporal lobe epilepsy
- Focal cortical dysplasia
- Post-traumatic seizures
- Tumour-related or vascular epilepsy
- Rasmussen’s encephalitis and other hemispheric syndromes
- Seizures after stroke or infection
Surgical options
- Anterior temporal lobectomy Removal of the seizure-producing part of the temporal lobe.
- Focal cortical resection Removal of a small, scan-identified area where seizures arise.
- Lesionectomy Removing a tumour, scar or vascular malformation that causes seizures.
- Corpus callosotomy Dividing the fibres that connect the two sides of the brain, for drop attacks.
- Vagus nerve stimulation (VNS) A device that sends mild pulses to the vagus nerve in the neck, used in selected patients.
Before the procedure
- Long-term video-EEG monitoring
- High-resolution MRI, and PET or SPECT where needed
- Memory, language and thinking tests
- Review at a multidisciplinary epilepsy meeting before surgery
- A discussion of realistic goals and risks
Recovery: what to expect
- A hospital stay of about 4 to 6 days for most resections.
- Seizure frequency is recorded after surgery.
- Most people return to daily life in 2 to 4 weeks.
- Medicines are reduced slowly if seizures stop.
- A follow-up EEG at about 3 and 6 months.
- Support for school and behaviour in children.
These are typical timings. Your own plan depends on your condition, your general health and the operation chosen, and Dr. Chakraborty will go through it with you.
Risks to know about
Every operation carries risk. The ones most relevant here are:
- Infection, bleeding or swelling
- Visual field loss or changes in memory or language, depending on the area
- Seizures continuing or returning
- Mood changes
Your own risks depend on your health and your scans, and are explained in detail before you decide on anything.
Common questions
How likely is surgery to stop the seizures?
It depends on the cause and the area. For a well-defined single focus, many people have a good result. The estimate for your case is discussed after assessment.
Is the brain damaged by surgery?
The assessment is meant to protect important functions, and the aim is to treat only the area causing the seizures.
What if the seizures return?
Medicines can be adjusted, and in some cases more surgery or another treatment is possible.
Is it safe for children?
Yes, with specialist assessment. Early treatment may help protect development.
This page is general information to help you prepare for a consultation. It is not medical advice and does not replace an examination. Every plan is made for the individual patient.