Epilepsy Surgery
The main types of epilepsy surgery include:
- Vagal nerve stimulation (VNS) can be used in generalized or focal epilepsy. [Welch: 2018] A VNS reduces seizure frequency by sending regular, low amplitude pulses of electricity to the brain via the vagus nerve. A stimulator device is implanted under the skin in the chest and is about the same size as a cardiac pacemaker. A wire from the device is wound around the vagus nerve in the neck. See Vagus Nerve Stimulator (VNS) for more information.
- Responsive neuro-stimulation (RNS) is a relatively new therapy. A device is placed in the skull that is connected to electrodes on top of the brain with the placement tailored to the individual. It monitors brain waves, and if seizure activity is detected, it stimulates the brain to try to counter the seizure activity.
- Lobectomy/lesionectomy (most frequently involving the temporal lobe) is a procedure in which a specific lobe (or lesion within a lobe) of the brain is removed. This is successful in many cases, especially when a lesion is identified on MRI. [Stevelink: 2018] The percentage of cure or significant seizure reduction varies with different criteria/methods used.
- Corpus callosotomy is a palliative surgery in which the main connection between right and left halves of the brain is cut. It is used most often to reduce injuries related to abrupt drop seizures, but seizure freedom should not be expected.
- Hemispherectomy/hemispherotomy is a procedure in which half of the brain is removed or disconnected from the surrounding brain. This is a palliative surgery that may result in more significant functional loss (peripheral vision loss, weakness) on the opposite side of the body, but it also has remarkable success in stopping seizures (60-80% depending on circumstances). This has shown to be particularly effective in instances where a prior stroke has caused epilepsy.
Resources
Services for Patients & Families in Idaho (ID)
Service Categories | # of providers* in: | ID | NW | Other states (5) (show) | | MT | NM | NV | RI | UT |
---|---|---|---|---|---|---|---|---|---|---|
Epilepsy Clinics | 2 | 1 |
For services not listed above, browse our Services categories or search our database.
* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.
Helpful Articles
Steinbok P, Gan PY, Connolly MB, Carmant L, Barry Sinclair D, Rutka J, Griebel R, Aronyk K, Hader W, Ventureyra E, Atkinson
J.
Epilepsy surgery in the first 3 years of life: A Canadian survey.
Epilepsia.
2009.
PubMed abstract
Benifla M, Rutka JT, Otsubo H, Lamberti-Pasculli M, Elliott I, Sell E, RamachandranNair R, Ochi A, Weiss SK, Snead OC 3rd,
Donner EJ.
Long-term seizure and social outcomes following temporal lobe surgery for intractable epilepsy during childhood.
Epilepsy Res.
2008;82(2-3):133-8.
PubMed abstract
Page Bibliography
Englot DJ, Ouyang D, Garcia PA, Barbaro NM, Chang EF.
Epilepsy surgery trends in the United States, 1990-2008.
Neurology.
2012;78(16):1200-6.
PubMed abstract / Full Text
Kadish NE, Bast T, Reuner G, Wagner K, Mayer H, Schubert-Bast S, Wiegand G, Strobl K, Brandt A, Korinthenberg R, van Velthoven
V, Schulze-Bonhage A, Zentner J, Ramantani G.
Epilepsy Surgery in the First 3 Years of Life: Predictors of Seizure Freedom and Cognitive Development.
Neurosurgery.
2018.
PubMed abstract
Pindrik J, Hoang N, Smith L, Halverson M, Wojnaroski M, McNally K, Gedela S, Ostendorf AP.
Preoperative evaluation and surgical management of infants and toddlers with drug-resistant epilepsy.
Neurosurg Focus.
2018;45(3):E3.
PubMed abstract
Prideaux L, Barton S, Maixner W, Harvey AS.
Potential delays in referral and assessment for epilepsy surgery in children with drug-resistant, early-onset epilepsy.
Epilepsy Res.
2018;143:20-26.
PubMed abstract
Stevelink R, Sanders MW, Tuinman MP, Brilstra EH, Koeleman BP, Jansen FE, Braun KP.
Epilepsy surgery for patients with genetic refractory epilepsy: a systematic review.
Epileptic Disord.
2018;20(2):99-115.
PubMed abstract
Welch WP, Sitwat B, Sogawa Y.
Use of Vagus Nerve Stimulator on Children With Primary Generalized Epilepsy.
J Child Neurol.
2018;33(7):449-452.
PubMed abstract