When seizures continue despite two or more suitable medicines, or are caused by a visible abnormality in the brain, surgery may offer the best chance of control. Before any operation, the child goes through a detailed assessment to find where the seizures begin and to make sure that speech, movement and vision areas can be protected.
Who it may help
- Seizures that continue after at least two suitable anti-seizure medicines
- Frequent, long or dangerous seizures, such as sudden drops or prolonged episodes
- An MRI showing a cause such as cortical dysplasia or a tumour
- Seizures that are affecting learning, behaviour or development
- A seizure focus in an area that can be removed safely
Conditions treated
- Focal epilepsy with a clear starting point
- Tuberous sclerosis
- Focal cortical dysplasia
- Hemimegalencephaly and Rasmussen’s encephalitis
- Tumour-related epilepsy, such as DNET and ganglioglioma
- Temporal lobe epilepsy in older children
Assessment and operations
- Epilepsy-protocol MRI A high-resolution scan looking for subtle abnormalities.
- Video-EEG monitoring Recording seizures in hospital, often over one to two weeks.
- Functional testing Mapping of the areas for movement, language and vision, and neuropsychological assessment.
- Resective surgery Removing the seizure-causing tissue or lesion (focal resection, lobectomy or lesionectomy).
- Disconnection procedures Hemispherotomy or corpus callosotomy for selected severe cases.
Before the procedure
- One to two weeks of EEG monitoring in hospital where needed
- Functional and developmental testing
- A discussion of goals and risks with the family
- Pediatric anaesthesia check
Recovery: what to expect
- A hospital stay of about 5 to 7 days.
- Intensive-care observation in the first 24 to 48 hours.
- Seizures are logged after discharge.
- Medicines are reduced gradually and only if the child stays seizure-free.
- Rehabilitation and school support as needed.
- Repeat EEG at about 3 and 6 months.
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:
- Bleeding, infection or swelling
- A new deficit in movement, vision or language, depending on the area
- Seizures that continue or return
- A need for further surgery
Your own risks depend on your health and your scans, and are explained in detail before you decide on anything.
Common questions
Is the rest of the brain affected?
Mapping and monitoring are used so that only the affected area is treated and important functions are protected.
Will my child still need medicines?
At first, yes. If the seizures stay away, the medicines may be reduced gradually.
Can surgery cure epilepsy?
Many children become seizure-free, and others have fewer seizures. The likelihood depends on the cause and is discussed after assessment.
Will it affect learning or speech?
Detailed testing before surgery is meant to avoid the areas critical for these functions.
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.