Epilepsy surgery: a guide for patients and families.
If you have seizures that keep happening despite medication, you may be a candidate for epilepsy surgery. This guide explains how we evaluate patients for surgery, what the different operations are, what they can and cannot do, and what to expect in the hospital and at home. It is written in the plain language we would use in clinic.
You will receive a lot of information as you go through this process. Read what is useful now and come back to the rest when you need it. Nothing here replaces the conversations you will have with your own neurologist and neurosurgeon, who will discuss the specific plan and risks for you.
Why surgery comes up.
Some people with epilepsy continue to have seizures despite medication. Doctors call this drug-resistant or intractable epilepsy. Some people take several medications and still have seizures. Others respond to a medication at first and then stop responding. When medications are not working, it is time to ask whether surgery could help.
A surgical evaluation has three goals: to identify the types of seizures you have, to locate where in the brain they start, and to recommend the treatment most likely to help you. Not everyone who is evaluated ends up having surgery. The evaluation itself often clarifies the diagnosis and improves care even when surgery is not the answer.
How this guide is organized.
The evaluation. What happens during Phase 1 testing in the epilepsy monitoring unit, what each imaging test looks for, what stereo EEG involves, and how our surgical conference reaches a recommendation.
Types of surgery. Resection, laser ablation, responsive neurostimulation, and hemispherotomy, with what to expect after each one.
Benefits and risks. What surgery can change in your life, what it cannot promise, and the risks you should weigh.
Common questions. Practical questions about the hospital stay, visitors, recovery, and returning to normal life.
Information videos.
Dr. Richardson has recorded presentations for patients and families on epilepsy surgery. They cover much of the same ground as this guide in a different format.
Epilepsy surgery information videos →
If you have a generalized epilepsy such as juvenile myoclonic epilepsy or absence epilepsy, a separate page describes responsive neurostimulation of the thalamus for that condition.