Phase IV is the final step of the seizure surgery process. This Phase is marked by the post-operative recovery period and follow up clinic appointments. Following hospital discharge, patients are seen by our neurosurgeon after about a week for immediate post-operative follow-up to ensure healing and recovery and removal of any sutures or staples. From then on, the neurology team (the patient’s clinic attending physician) meets the patient at regular intervals to monitor the impact of surgery on seizures. Ideally, seizures are much reduced or eliminated immediately after surgery. Anticonvulsants may be reduced after a period of time (normally a year or two) if progress remains good. Our neurosurgeon also arranges regular visits with the patient for about six months after surgery, after which the patient may be discharged, though the neurology team generally maintains contact and follow-up for several years. Six months after surgery is also the time where repeat neuropsychology evaluation is requested, to assess the impact of surgery on the patient’s language, memory and other cognitive abilities. Often there is a noticeable improvement in mental function, due to the decrease or absence of seizures, and as anticonvulsant medications are withdrawn, there may be further improvement over the longer term.
Information for Patients
You will see our neurosurgeon in clinic about seven to ten days after surgery to make sure you are healing well and to have any sutures or staples removed. Depending on the exact surgery, some restrictions on your physical activity may be placed for a few weeks, such as avoiding heavy lifting or air travel. You will also see your clinic epilepsy doctor after about 6 weeks, and then at regular intervals thereafter. Your doctor will normally advise that you continue all seizure medications as you did prior to surgery. At a later time – usually one or two years – and depending on progress, your doctor will discuss tapering seizure medications. Most of our patients continue taking some medications over the long term, though occasionally it is reasonable to stop all medications if seizures completely disappear. Some routine tests, such as a repeat MRI of the brain, EEG and neuropsychology will be requested about 6 months after surgery to fully assess the impact of surgery.
Please feel free to reach out to our epilepsy surgery nurse practitioner Debbra Livingston with questions or concerns about this process. Often, a phone call may be sufficient to answer questions, but Debbra also runs a separate nurse-run clinic, where there is the opportunity for detailed face-to-face discussion.