Epileptic seizures involve a sudden surge of electrical activity in the brain that causes electrical impulses to be transmitted to the muscles, causing twitches or convulsions. They can strike at any time and are often disruptive to daily life. Many patients control their epilepsy with medication, but surgery is sometimes an option when medications fail. Though not considered until multiple medications and medication combinations have failed, surgery to relieve epilepsy is considered earlier than it was in the past. When the brain tissue itself is at fault, surgeons can remove the part of the brain that triggers seizure activity. This type of surgery, known as a resection surgery, is the most common surgery for epilepsy and is only attempted if doctors feel they can remove the damaged part of the brain without affecting important bodily functions. Other types of surgery include multiple subpial transection and corpus callosotomy, both aimed to interrupt the nerve pathways that allow seizures to spread. Surgery is not an option for those in generally poor health or for patients whose seizure activity cannot be traced to a specific area of the brain. Resection surgery stops or reduces seizures in many people, but is not without risks. Each individual is encouraged to discuss their options with their doctor.
If you do opt for surgery, a small portion of your head will be shaved before the procedure. While you are under anesthesia, a small section of your skull will be removed and the surgery performed. Your skull will then be replaced and the wound closed. You will take pain medication to reduce discomfort and will need between one to three months to fully recover. Most people who have epilepsy surgery do not need physical or occupational therapy, but do comply if your doctor recommends these activities for you. If you have a seizure soon after the procedure, your doctor may recommend undergoing a second surgery to remove more brain tissue. Once you have fully recovered, your seizures should be eliminated or greatly reduced in number and severity. Doctors have found that epilepsy resection surgeries have better outcomes when they are performed earlier rather than later. As a result, surgery is typically recommended after only one or two years of uncontrolled seizure activity.