Epilepsy is a condition that causes repeated seizures and can greatly affect a person’s daily life. While medicines help many patients, about one-third continue to have seizures despite treatment. For these individuals, surgery can be a life-changing option. But how does epilepsy surgery work? Who can benefit from it? Is it safe? In this blog, we answer common questions about surgical treatment options for epilepsy, helping patients and families understand when and why surgery should be considered.
Q1: What Is Epilepsy, And Why Is It A Serious Problem?
A: Epilepsy is a neurological disorder characterized by recurrent seizures caused by abnormal brain activity. It affects people of all ages and can lead to significant physical, emotional, and social challenges. Seizures can be unpredictable and, in some cases, life-threatening.
Q2: How Common Is Epilepsy?
A: Epilepsy affects approximately 50 million people worldwide, making it one of the most common neurological conditions. About 30% of patients continue to have seizures despite taking medications.
Q3: How Does Epilepsy Impact A Person’s Life?
A: Frequent seizures can interfere with daily activities, education, and employment. Many patients / parents face social stigma and mental health issues such as anxiety and depression. It can lead to financial strain, adding to the burden on families.
Q4: What Is Drug-Refractory Epilepsy?
A: Drug-refractory (or drug-resistant) epilepsy is when seizures persist despite trying at least two appropriate anti-seizure medications. This affects about one-third of epilepsy patients, making them potential candidates for surgical treatment.
Q5: Why Should Surgery Be Considered Early For Some Patients?
A: Delaying surgery can cause further brain damage due to repeated seizures. Studies show that early surgery improves long-term seizure control, cognitive function, and quality of life.
Q6: When Should A Patient Consider Epilepsy Surgery?
A: Surgery is considered when:
- Seizures are frequent and disabling.
- Medications fail to control seizures.
- Tests show that seizures originate from a specific brain area that can be safely removed without affecting vital functions.
Q7: What Are The Surgical Options For Epilepsy?
A: Several surgical treatments exist, including:
- Resective surgery – Removing the brain area responsible for seizures, such as in temporal lobectomy, the most common and successful procedure.
- Laser ablation (LITT) – A minimally invasive technique using laser heat to destroy seizure-causing tissue.
- Corpus callosotomy – Cutting the connection between brain hemispheres to reduce seizure spread, usually for severe cases.
- Deep Brain Stimulation (DBS) and Vagus Nerve Stimulation (VNS) – Devices implanted to reduce seizure frequency in patients who are not surgical candidates.
Q8: How Is Epilepsy Surgery Performed?
A: Surgery is done under general anesthesia. Advanced brain mapping and imaging techniques, such as MRI, EEG, and PET scans, help identify the seizure focus. In some cases, awake surgery is needed to ensure safety.
Q9: What Happens After Surgery?
A: Post-surgical rehabilitation includes:
- Medication adjustments
- Speech, physical, or occupational therapy if needed
- Regular follow-ups to monitor progress
Q10: What Are The Success Rates Of Epilepsy Surgery?
A: Success depends on the type of epilepsy and surgery performed. Temporal lobectomy has up to an 80% seizure-free success rate. Other surgeries significantly reduce seizure frequency, improving quality of life.
Q11: What Are The Benefits Of Surgery?
A: – Better seizure control or complete seizure freedom
- Reduced medication dependency
- Improved cognitive function and social life
- Increased ability to work, study, and carry out activities of daily life.
Q12: Is Epilepsy Surgery Safe?
A: Yes, modern surgical techniques have made epilepsy surgery safer with minimal complications. Risks include infection, bleeding, or neurological deficits, but these are rare in experienced hands.
Q13: What Should Families Consider Before Choosing Surgery?
A: Families should discuss the risks, benefits, and success rates with an epilepsy specialist. Surgery can be a life-changing decision, offering a chance for independence and a seizure-free life.
Conclusion:
For patients with drug-refractory epilepsy, surgery is a highly effective treatment that can significantly improve quality of life. Early evaluation for surgical options can help prevent years of uncontrolled seizures and their devastating consequences.
Dr. Harshal Agrawal is a dedicated Pediatric Neurosurgeon and Epilepsy Surgeon trained in India and abroad. Consult him today if your child is suffering from drug-refractory epilepsy.