Epilepsy Surgery

Treatments & Procedures:

• Epilepsy Surgery: Removes the part of the brain where seizures start
• Vagus Nerve Stimulation (VNS): A small device placed under the skin to send signals to the brain and reduce seizures
• Responsive Neurostimulation (RNS): A device placed in the brain that detects and responds to seizure activity
• Deep Brain Stimulation (DBS): Electrodes are placed in specific brain areas to help control seizures
• Imaging and EEG Monitoring: Used to locate the seizure focus

Conditions Treated:

• Severe epilepsy with drop seizures
• Generalized seizures that don’t respond to medicine

Before the Procedure:

Testing includes EEG, imaging, and seizure observation. The surgery is done under general anesthesia, and part or all of the corpus callosum is divided.

After the Procedure:

You’ll stay in the hospital for a few days. Some seizures may continue but become less harmful. Therapies may help with speech, movement, or memory changes after surgery.

Before the Procedure:

Before DBS, patients go through a thorough evaluation to determine if they are good candidates.

After the Procedure:

After the procedure, the device is adjusted over time to optimize results. Recovery includes follow-up visits and coordination with neurology and therapy teams.

Conditions Treated:

• Medically refractory epilepsy (drug-resistant epilepsy)
• Focal epilepsy (seizures starting in one area of the brain)
• Severe childhood epilepsy affecting one hemisphere

Before the Procedure:

You’ll have several tests such as MRI, EEG, and seizure mapping to find where seizures start. Your care team will explain which part of the brain may be removed or disconnected and how this may affect speech, movement, or memory.

After the Procedure:

Recovery usually includes a hospital stay, followed by physical, occupational, or speech therapy if needed. Many patients see a major reduction in seizures, and some become seizure-free. Medications may still be continued after surgery, but often at lower doses. Children who have a hemispherectomy may need longer rehabilitation to help with strength, movement, and communication.

Conditions Treated:

• Brain tumors (primary or metastatic)
• Epilepsy that does not respond to medication
• Radiation necrosis (damaged brain tissue after radiation therapy)
• Certain abnormal brain lesions

Before the Procedure:

Before LITT, you will have imaging studies, such as an MRI, to help your care team plan the treatment. Your neurosurgeon will review your medical history, medications, and symptoms. You may be asked to stop certain medicines before the procedure. Most patients are admitted to the hospital on the day of surgery.

After the Procedure:

After LITT, you will be monitored in the hospital, often for one to two days. Some swelling or temporary symptoms can occur as the treated tissue heals. Most patients experience less pain and a faster recovery compared to open brain surgery. Your care team will schedule follow-up visits and imaging to track healing and results.

Conditions Treated:

• Medically refractory epilepsy (especially focal seizures)

Before the Procedure:

You’ll have brain imaging, EEG testing, and seizure mapping to find the seizure focus. The procedure is done under general anesthesia.

After the Procedure:

The device records brain activity and adjusts over time. You’ll visit your provider to review data and make changes to improve seizure control. Most people continue taking seizure medicine.

Conditions Treated:

• Drug-resistant epilepsy
• Seizures not controlled with medication
• Epilepsy with unclear seizure origin

Before the Procedure:

Before intracranial monitoring, you will have detailed brain imaging and other tests to plan where electrodes should be placed. On the day of surgery, a neurosurgeon will place the electrodes through small openings in the skull, guided by advanced imaging. You will stay in the hospital for monitoring, usually in a specialized epilepsy unit. Your team may adjust medications to encourage seizures so they can be recorded.

After the Procedure:

You will remain in the hospital until enough seizure data is collected, which can take several days to a few weeks. During this time, you will be closely monitored by your care team. Once monitoring is complete, the electrodes are removed in a minor procedure. Your doctors will then review the results and discuss next steps, which may include surgery, other procedures, or changes to your treatment plan. Some temporary side effects, such as headache or mild swelling, may occur but usually improve after the electrodes are removed.

Conditions Treated:

• Medically refractory epilepsy
• Treatment-resistant depression (in some cases)

Before the Procedure:

You’ll have imaging and testing to confirm that VNS is right for you. The procedure is done under general anesthesia, and you’ll be asleep and comfortable.

After the Procedure:

You may go home the same day or after a short stay. The device is turned on during a follow-up visit and adjusted over time to help control seizures. You might feel a slight tingling in your throat during stimulation.