Epilepsy surgery is an extensive field of specialization within neurosurgery as a whole. Since its beginnings in the 1930s, epilepsy surgery is now well-recognized as a highly effective treatment for certain types of patients with difficult, medication-resistant epilepsy. At the University of Florida, we have performed over 1500 surgeries for epilepsy since 1992, and today possess all the requisite technology and expertise to provide the most advanced surgical treatments for epilepsy. Despite its complexity, surgery for epilepsy can broadly be divided into a few classes.
- Resective procedures, where a portion of the brain identified as harboring the seizure focus is removed. The best-known example is temporal lobectomy, where the anterior portion of the temporal lobe as well as the deep limbic (amygdala-hippocampus) are removed. Temporal lobectomy remains a highly effective treatment for epilepsy in carefully selected patients.
- Disconnective procedures, where a portion of the brain is disconnected from the rest of the brain to stop the spread of seizures. Corpus callosotomy is a common such disconnective procedure, where the two halves of the brain (cerebral hemispheres) are disconnected to stop the spread of seizures from one side to the other.
- Ablative procedures, a relatively recent innovation, where a probe is inserted into the seizure-producing area of the brain and gentle heat applied to destroy it. Formally known as laser interstitial thermal therapy, a common example are patients who in the past were treated with temporal lobectomy but may equally benefit from LITT.
- Neuromodulatory procedures, where brain is not removed or disconnected but electrically stimulated, either indirectly through a peripheral afferent pathway (vagus nerve stimulation) or central afferent pathway (deep brain stimulation) or directly targeting the epileptic focus (responsive neurostimulation). Neuromodulation is a rapidly developing surgical treatment for epilepsy, and can be effective for patients who are unsuited to other types of treatment.
Information for patients
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