When seizures cannot be controlled with medication, a neurologist may recommend surgery. Surgery for epilepsy is a well-established procedure with very good results. Surgery is done only on patients who meet strict criteria. The patient must first undergo extensive testing to make sure that the seizures start from a site that can be identified and safely removed without causing loss of important functions.
Types of surgery
A lesionectomy removes a small area of abnormal tissue where a seizure occurs or starts. A lobectomy removes part of one lobe of the brain. A partial temporal lobectomy is the most commonly performed surgery.
In severe cases of generalized atonic seizures or drop attacks, another form of surgery called a corpus callosotomy may be performed. In this procedure, the membrane between the right and left sides of the brain is severed. This prevents seizure activity from spreading to both sides of the brain, reducing the frequency and severity of seizures.
A Canadian study compared the use of surgery versus anticonvulsants for seizure control, in persons with uncontrollable temporal lobe seizures. At one year post surgery, 58% were free of seizures that impaired awareness. Only 8% of the non-surgery control group was seizure-free. Quality of life was also greater in the group who received surgery.
For more information about the study, see: