Brain surgery is a viable treatment for epilepsy. More so than in the past, surgery is being considered sooner in the treatment of epilepsy. Once thought of as a “last resort”, it is often a second option following medication due to its progress. Surgery is likely to be considered as a treatment option when:
- You have tried anti-seizure medications without success.
- You have seizures that always start in one, identifiable part of the brain.
- You have seizures occur in a part of the brain that surgery can safely be performed on and will not affect your ability to live your life freely.
The most important prerequisite of a successful surgery is accurate identification of the origin of your seizures. Four tests are most frequently done in order to determine the brain area of origin: EEG monitoring, Neuropsychological testing, Intracarotid Sodium Amobarbital Procedure (ISAP), nicknamed the “Wada test”, which looks at which side of the brain that language and memory are controlled by, and Magnetic resonance imaging (MRI). Additional tests like the Positron Emission Tomography (PET), depth electrodes and/or subdural grids may be used as well. All of these tests give the surgeon information to make sure a person is a viable candidate for successful surgery.
In addition to surgeries that remove part of a patient’s brain, some surgeries can be performed to interrupt the spread of electrical disturbances in a person’s brain. During this type of surgery, patients are often kept awake, and no pain is felt. Keeping the patient awake helps surgeons more closely monitor brain function.
For one to two years following surgery, anti-seizure medications are usually administered. If no seizures occur during this time, the patient is usually slowly weaned off the medication.
While these general situations tend to apply to a majority of people with epilepsy, it is important to always remember that every patient is different, therefore, every surgery is different. Sometimes, patients must continue medication for longer than a few years, sometimes shorter. Depending on each case, different surgeries may be performed. Hopefully, seizures can be controlled without surgery even being necessary. It is important to remember that each and every person is different, and no “general rule” applies to everyone.