Epilepsy surgery

Epilepsy surgery is a blanket term for several different types of procedures, each of which can be vastly different and used for different types of epilepsy. 

Surgery is usually one of the last options that will be suggested and is most common in people with epilepsy whose seizures cannot be controlled using anti-epileptic drugs (AEDs). The aim is to reduce the frequency and severity of seizures, or in some cases stop them altogether. 

Not all epilepsy types can be treated through surgery, so suitability will be predicated on the type of epilepsy that a person has. Unfortunately, for some people, surgery simply isn’t an option.  

Types of epilepsy surgery 

There are various types of epilepsy surgery, each involving a different procedure. Below we have outlined the various types of epilepsy surgery. 

Resection surgery

Resection surgery involves removing part of the brain that’s affected. These include:

Temporal lobectomy 

If the seizures arise in the temporal lobes, a temporal lobectomy may be very effective for some people. This means to remove part of the temporal lobe. 

Extratemporal resection 

If the seizures are arising in other areas of the brain, an extratemporal resection can be undertaken to remove the affected area.  

Lesionectomy 

A lesionectomy is a type of epilepsy surgery used to remove tumours, abscesses or any other type of trauma that may be causing seizures. 

Disconnection surgery 

Where resection surgery isn’t a possibility and part of the brain can not be removed, there are types of surgery whereby one part of the brain is disconnected from another. Including:

Hemispherectomy

During a hemispherectomy, the outer layer is disconnected from the half of the brain that is causing seizures. 

Corpus callosotomy

During this type of surgery, the connection between the two hemispheres of the brain are disconnected to prevent seizures from spreading from one side to the other. 

Multiple subpial transection 

During this type of surgery, the nerve fibres in the outer layers of the whole brain are severed to stop seizure activity from being able to spread throughout the brain. 

Other types of epilepsy surgery 

There are also types of surgery that don’t involve removing or disconnecting parts of the brain, these include: 

Vagus Nerve Stimulation (VNS)

VNS involves having a small generator implanted under the skin just below the left collarbone. This is connected to a lead with 2 coils that are attached to the vagus nerve which sends electrical impulses to the brain. 

Read more about vagus nerve stimulation here. 

Deep brain stimulation (DBS)

DBS involves having a DBS system fitted to stimulate the affected part of the brain. The system includes a thin, insulated wire placed in the part of the brain, as well as a neurostimulator, which is a device similar to a pacemaker. Again this is placed under the skin, usually under the left collarbone, but also lower in the chest or under the skin of the abdomen. 

Read more about deep brain stimulation here. 

 National Epilepsy Training can help

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