Epilepsy surgery

What is Epilepsy Surgery?

Epilepsy surgery involves removing or altering a part of the brain to stop seizures originating from that area. It is usually considered after patients continue to have seizures despite trying multiple medications. Surgery can include removing the seizure focus, interrupting pathways that spread seizures, or implanting devices to control brain activity.

A simple explanation for patients

In simple terms, epilepsy brain surgery means the surgeon will carefully operate on the part of your brain causing seizures to help stop them or make them less severe.

Why is Epilepsy and Brain Surgery Needed?

Surgery is considered when seizures are frequent and severe, interfering with daily life or causing injury, and medications don’t provide adequate control. If successful, surgery can dramatically reduce or eliminate seizures, improving safety, cognition, and independence.

Common Indications for Surgery

• Drug-resistant focal epilepsy originating from a specific brain region.

• Presence of lesions such as tumours or scars causing seizures.

• Frequent seizures cause significant impairment.

• Good overall health and ability to undergo surgery.

Types of Epilepsy Surgery

Several types of surgery are practised based on seizure origin and brain mapping results.

• Resective surgery: Removes the seizure-causing brain tissue.

• Lobectomy: Commonly involves temporal lobe tissue removal for temporal lobe epilepsy.

• Lesionectomy: Removal of tumours, scars, or vascular malformations causing seizures.

• Disconnection surgeries: Such as corpus callosotomy, where nerve pathways spreading seizures are cut.

• Laser interstitial thermal therapy (LITT): Minimally invasive laser ablation targeting seizure foci.

• Neuromodulation: Implantation of devices like vagus nerve stimulator or responsive neurostimulation.

Why Choose Manipal Hospitals for Epilepsy Brain Surgery?

We provide cutting-edge epilepsy care with a multidisciplinary team combining neurology, neurosurgery, neuropsychology, and rehabilitation, ensuring thorough evaluation and individualised treatment.

• Experienced neurosurgeons specialising in epilepsy surgery.

• Advanced brain imaging and invasive monitoring capabilities.

• Minimally invasive surgical options, including laser ablation.

• Comprehensive perioperative care and rehabilitation.

• Dedicated international patient coordinators ensure supportive care.

Indications for Epilepsy and Brain Surgery

Appropriate candidates have drug-resistant seizures localised to a resectable brain region, with good potential for improved seizure control and quality of life.

• Failure of two or more antiepileptic medications.

• Identifiable brain region causing seizures on EEG and imaging.

• Normal or acceptable cognitive baseline before surgery.

• Good physical health is required to tolerate surgery.

• Understanding of risks and expectations from surgery.

Who Should Avoid or Delay Epilepsy Surgery?

Surgery may be inappropriate for patients with poorly localised seizures, generalised epilepsy, significant cognitive impairment, or high surgical risk.

• Uncontrolled medical conditions.

• Diffuse or multifocal seizure origins.

• Psychiatric comorbidities limit rehabilitation.

• Inability to consent or cooperate with the process.

Preparing for Epilepsy Surgery

• Detailed seizure history and neurological examination.

• Advanced imaging such as MRI, PET, or SPECT scans.

• Prolonged video EEG monitoring to localise seizure focus.

• Neuropsychological and psychiatric assessments.

• Discussion of surgical options and potential outcomes.

• Planning for hospital stay and postoperative rehabilitation.

What Will Happen During Epilepsy Surgery?

Under general anaesthesia, the neurosurgeon will make a small craniotomy to expose the brain area identified as causing seizures. Using specialised techniques, including microscopes and brain mapping, the affected part is carefully removed or disconnected. Minimally invasive options, such as laser ablation, use a thin probe guided into the brain to destroy abnormal tissue. After surgery, you will be closely monitored in critical care.

Step-by-Step Breakdown

• Preoperative imaging and brain mapping.

• General anaesthesia and positioning.

• Craniotomy or burr hole creation.

• Microsurgical removal or ablation of the seizure focus.

• Surgical site closure and ICU transfer.

• Postoperative neurological monitoring.

• Gradual mobilisation and rehabilitation initiation.

Recovery After Epilepsy Brain Surgery

Hospital stay may range from a few days to a week, depending on the surgery type and patient condition. Pain and swelling are managed effectively. Rehabilitation and neuropsychological support aid in recovery and adaptation. Regular outpatient follow-ups monitor seizure control and medication adjustment. International patients benefit from telemedicine support for ongoing care.

Risks & Complications

Risks include infection, bleeding, neurological deficits, memory or cognitive changes, and seizures. However, thorough pre-op evaluation and expert surgical skill greatly minimise risks. Open communication allows realistic expectations.

Benefits of Epilepsy Surgery

Surgery can reduce or eliminate seizures, improve quality of life, reduce medication side effects, improve cognition, and allow increased independence.

Cost of Epilepsy Surgery

Costs are favourable compared to many countries and include surgery, hospitalisation, imaging, and rehabilitation. Personalised pricing plans are provided after assessment.

International Patient Support at Manipal Hospitals

We assist with visa applications, airport transfer, lodging, language support, dietary preferences, and insurance navigation. Dedicated coordinators ensure a smooth and supportive experience.