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Epilepsy surgery

Approximately 70% of people with epilepsy find their seizures can be controlled with medication. It is usual for a person with epilepsy to have tried at least two anticonvulsant medications at suitable doses before it is considered that medication may not be completely effective for seizure control.

For this group of people, it may be worth considering epilepsy surgery.

Deciding to have surgery for epilepsy is a big decision. The assessment process can take more than a year and treatment (in most cases) will involve major brain surgery.

Our consultants

  • Nilesh Mundil

What we do

Resective surgery

There are various causes of epilepsy, and for many people, the cause is unknown. Some people however, have a structural abnormality in part of their brain, which could be the cause. This could be something they were born with, such as scarring, or an area that did not develop properly. Alternatively, it could have developed in later life. As part of the assessment process, you will have a scan to see if the abnormal epileptic activity in the brain that occurs during a seizure starts in the same area as the abnormality. Resective surgery would involve removing this part of the brain.

Functional procedures

If the area is not removable, it may be possible to affect the way a part of the brain works without removing any brain tissue. Vagal nerve stimulation is an example of this type of surgery.

Alternatives to surgery

If surgery is not suitable, your condition will continue to be managed by medication. The consultant neurologist in the epilepsy surgery team is experienced in managing medication and may be able to suggest changes to improve the control of your seizures. However, it is worth remembering that with each new medication, the chances of your seizures becoming completely controlled becomes less.

Surgical assessment process

To identify which patients are suitable for surgery, each patient will undergo an intensive assessment process. Tests may include an EEG, a detailed brain scan, video telemetry (involving a week long stay in hospital) and assessment by a psychologist and psychiatrist. Find out more about the tests and investigations we carry out.

The epilepsy surgery team meet to discuss the assessment results of patients every fortnight. You will be offered an appointment with the consultant and depending on the test results, the options will be:

  • Surgery is not a suitable option
  • Surgery can be considered
  • Further tests are required

Outlined below are some of the tests that the epilepsy surgery team may need to perform during your assessment for surgery.

These are used less commonly, and not all patients will require them.

Before and after your surgery

Before surgery

After surgery