Surgery for Treating Adult Epilepsy
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Who Should Consider Adult Epilepsy Surgery?
Epilepsy is a disorder that results from surges in electrical signals inside the brain, causing recurring seizures.
Usually, medication can bring seizures under control. However, in one third of people with epilepsy, seizures persist despite trials of numerous drugs.
If two different medications can not help control a patient's seizures, epilepsy surgery may be an effective option.
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Determining if Epilepsy Surgery is Needed
Before recommending surgery, the neurosurgeons at the UPMC Movement Disorders and Epilepsy program must determine that:
- The patient's seizures are continuing after trying two different medications.
- The patient's seizures arise from one site in the brain.
- The site of the seizures has been pinpointed.
- The removal of the portion of the brain causing the seizures will not impair the patient's ability to function.
Mapping brain function prior to surgery
Using state-of-the-art brain imaging technology, UPMC neurosurgeons are able to determine the part of the brain responsible for seizures. After the area is found, neurosurgeons perform extensive testing to determine any major problems with speaking, understanding, or other abilities that could arise if that area of the brain is removed.
In some cases, neurosurgeons briefly interrupt the function of the part of the brain considered for surgical removal and ensure that the patient can still do all the things he or she can ordinarily do.
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Types of Adult Epilepsy Surgery
If surgery is appropriate for treating your adult epilepsy, UPMC neurosurgeons perform an array of safe and effective surgical interventions.
Resection of seizure focus: Using a combination of preoperative and intraoperative brain mapping, this procedure involves removing the area of the brain that is causing seizures. As the most common type of epilepsy surgery, patients often experience a 50-90 percent success rate for complete seizure relief. This procedure may also be effective for patients who have epilepsy located in areas of the brain other than the temporal lobe, or for patients who have been told that their epilepsy is inoperable.
Multiple subpial transection: This procedure involves making small incisions in the brain to interrupt seizure activity and is performed when seizures originate in areas of the brain that cannot be removed safely.
Vagus Nerve Stimulation: The vagus nerve serves as one of many highways of information carrying messages to and from the brain. Because of its many connections to areas in the brain, the vagus nerve can be a key target for treating epileptic seizures. During the procedure, a vagus nerve stimulator (VNS) is implanted under the skin near the collarbone. A wire under the skin connects the device to the vagus nerve in the neck. Neurosurgeons then program the device to produce weak electrical signals that travel along the vagus nerve to the brain at regular intervals. These signals help prevent the electrical bursts in the brain that cause seizures.
After the stimulator is implanted, a battery-powered device is programmed that allows patients to turn the device on if they feel a seizure about to start. Patients can also turn the device off if it is causing unpleasant side effects.
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Appointments or More Information
To schedule an appointment at UPMC's Movement Disorders and Epilepsy program, or for more information about our programs and services, call 412-647-3685.
For international calls, please dial 01-877-320-8762.
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