Neurosurgery for Epilepsy

Epilepsy surgery is a neurosurgical procedure aimed at removing or altering the area of the brain where seizures originate to reduce or eliminate seizures.

Candidates for epilepsy surgery are typically patients who have not responded to medication after trying multiple antiepileptic drugs and continue to experience debilitating seizures.

Common types of epilepsy surgery include resective surgery, laser interstitial thermal therapy (LITT), disconnection procedures like corpus callosotomy, and neurostimulation techniques such as vagus nerve stimulation (VNS) and responsive neurostimulation (RNS).

The surgical area is identified using advanced imaging techniques such as MRI, PET scans, and EEG monitoring, often combined with inpatient video EEG monitoring and neuropsychological testing.

Risks include infection, bleeding, neurological deficits, memory loss, and changes in cognition or behavior. Discussing specific risks with a neurosurgeon is crucial.

Success rates vary depending on the type of surgery and the patient’s condition. Resective surgery can result in seizure freedom for approximately 60-80% of patients, while other procedures may reduce seizure frequency.

Recovery time varies but generally involves a hospital stay of a few days to a week, followed by several weeks to months of gradual recovery and rehabilitation.

Many patients continue to take antiepileptic drugs for months or even years after surgery. The goal is to eventually reduce or stop medications, but this is determined on an individual basis.

Lifestyle changes may include modifications to activities during recovery, ongoing medication management, and regular follow-ups with healthcare providers to monitor seizure activity and overall health.

Preparation involves a thorough evaluation by a multidisciplinary team, which may include imaging studies, neuropsychological testing, and sometimes an inpatient stay for video EEG monitoring.

Yes, epilepsy surgery is generally covered by the NHS for eligible patients. However, eligibility needs to be established through comprehensive assessments performed by specialist teams.

Follow-up care involves regular appointments with your neurosurgeon and neurologist, medication adjustments, and possibly additional therapies such as occupational or speech therapy, depending on your recovery.

Yes, children can undergo epilepsy surgery, especially if their seizures are significantly affecting their quality of life and are not controlled by medication. Assessments and procedures are tailored specifically for the paediatric population.

Psychological effects can vary: some patients experience improvements in mood and quality of life, while others may face challenges such as anxiety or depression. Psychological support and counselling are important aspects of the recovery process.

While epilepsy surgery can significantly reduce or eliminate seizures, there is a possibility that seizures may return. Continuous monitoring and follow-up care are essential for managing any potential recurrence.