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Welcome pageWhat's NewCNI Epilepsy Center
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Our specialists are happy to discuss your individual case with you. Serious inquiries only, please. For an appointment, call 303-788-4600. For other information
about CNI's Epilepsy Center, send
e-mail or call |
The initial treatment for seizure disorders is medication. However, for some patients, medications do not completely stop or control seizures and surgery may be an option. The goal of epilepsy surgery is to improve seizure control. In many cases, the procedure can completely stop seizures.
To find out about other potential treatment options for epilepsy, please go to the CNI Research Department's Clinical Trial reruitment page.
The first epilepsy surgery was performed over 100 years ago. With improvements in surgical techniques in the diagnosis of seizure disorders, surgery is now a standard treatment option for some patients.
Several types of epilepsy surgeries exist. The three major types are:
Lobectomies
Hemispherectomies
Corpus Callosotomies
The type of surgery depends on the type of seizures. Epileptic seizures are presently classified into two specific types:
Seizures that begin in part of the brain (partial seizures)
Seizures that begin all over the brain (generalized seizures).
Lobectomies are used to treat partial seizure disorders. This procedure involves removing tissue from the frontal, temporal, parietal, or occipital lobe. Only that small part of the brain that is thought to be damaged and causing seizures is removed. Some parts can be removed safely but since each lobe of the brain performs specific functions minor deficits may occur. It is important for the patient to completely understand the possible deficits that may result from surgery in that area.
Hemispherectomy is indicated for partial seizure disorders and occasionally for certain generalized seizure problems. This procedure is usually performed on children with severe, frequent seizures. Of all the surgical procedures, hemispherectomy has the highest success rate in stopping seizures.
Corpus Callosotomy is used in the treatment of generalized seizures such as generalized tonic clonic seizures and also atonic seizures commonly called "drop seizures". This procedure involves disconnecting the fibers between the two halves (hemispheres) of the brain. This procedure is not a cure for epilepsy. However, it may stop or significantly limit the number of "drop seizures" and decrease the chance of injuries commonly caused by these attacks.
Evaluation
Before SurgeryThe patient that elects to have surgical treatment usually undergoes several stages of evaluation. The first stage is a pre-surgical evaluation. At this point, many relatively safe and easy tests are done. These tests include may include routine EEGs, MRI, and SPECT scans. A critical part of the evaluation is video-EEG monitoring, which actually records seizures. It is performed in the hospital setting. Neuropsychological evaluation is another essential part of the work-up and can usually be done as an outpatient. When all of this testing is complete, the patient may move on to a more invasive evaluation, which may include a Wada test, and intracranial electrode evaluation, which involves the surgical placement of electrodes to further localize the site of seizure activity.
When all of the testing is complete, and it has been determined that the seizure focus can be safely removed, surgery is scheduled. Recordings take place in the operating room to confirm the location of the seizure activity.
Certain risks must be considered
when contemplating epilepsy surgery. It is important for each patient
to discuss these with his or her doctor before considering this treatment
option. Outcomes can vary and patients need to be aware of the risks and
potential complications prior to beginning the long evaluation process
that may be needed.
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Colorado Neurological
Institute Epilepsy Center
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