Epilepsy Surgery

Some epilepsy patients may experience a condition known as medically refractory epilepsy or drug-resistant epilepsy.

Epilepsy surgery can be an effective treatment option when more than two anti-seizure medication trials fail to control seizures. It’s important to be evaluated at an epilepsy center to see if you’re a candidate for epilepsy surgery.

Surgical Therapies

Vagus Nerve Stimulation (VNS) consists of a device that is implanted under the skin in the left chest area. An electrode or wire is attached to the generator device and placed under the skin. The wire is attached or wrapped around the vagus nerve in the neck. The device is programmed to give stimulation at regular intervals, alternating between periods of stimulation and no stimulation.  

Responsive Neuro Stimulation (RNS) is available to people who cannot have resective surgery or laser ablation. RNS may be an option for many people previously not considered candidates for epilepsy surgery, such as those with a seizure focus in a critical part of the brain (near speech, vision, or movement centers) or those with more than one seizure focus. This is because RNS therapy does not remove brain tissue, and the leads can be placed in or on more than one brain region. The neurostimulator continuously monitors the brain’s activity and is programmed by the neurologist to detect and record specific patterns that could lead to a seizure. When these patterns are detected, the neurostimulator responds with brief pulses of stimulation intended to disrupt the abnormal brain activity before a seizure occurs.

Deep Brain Stimulation (DBS) Therapy involves placing a device implanted deep within the brain, emitting regular electrical signals that disrupt seizure-causing activity. The procedure is guided by MRI, and the electrical pulse generator is implanted in the chest.

Laser Interstitial Thermal Therapy (LITT) is a less invasive alternative to resective surgery. It employs a laser to precisely destroy a small section of brain tissue. Magnetic resonance imaging (MRI) is used to guide the laser during the procedure.

Minimally Invasive and Traditional Surgical Options

Stereoelectroencephalography (SEEG) is a minimally invasive procedure that employs advanced technology to implant as many as 20 electrodes through tiny openings in the skull and into the brain tissue. The goal of this procedure is for the surgical team to pinpoint the precise origin of a patient's seizures so that the most suitable surgical intervention to either stop or reduce them can be identified. Following the procedure, your surgical team will discuss the recommendations for the best outcomes and personalized care for your unique needs.

Prior to the SEEG procedure, patients will complete a stay at UI Health’s Epilepsy Monitoring Unit (EMU) so that their doctors and neurosurgeons can understand more precisely the type and location of a patient’s seizures.

Functional Hemispherectomy is primarily used in children, this procedure severs connecting nerves without removing actual brain tissue, offering a less invasive approach to address certain seizure-related issues.

Focal Resection procedure involves removing the portion of the brain where seizures originate.

Most patients can go home the day after treatment and can quickly return to normal activities. The main benefits of less invasive surgery are faster recovery time, shorter hospital stays, minimal post-procedure pain, and little or no hair removal at the treatment site.

Hemispherectomy is a treatment that involves removing almost all of one hemisphere, or side, of the brain. This procedure is typically only performed on newborns and children whose brains are capable of compensating for the removal of so much tissue.