What type of seizures do they do surgery for?

[jenagade]

First let me say that I am learning so much on this forum, most of it helpful, some a bit scary.

I always thought that surgery for seizure control was a rare last ditch attempt sort of thing but it seems more common than I thought.

What I'm interested in knowing is what types of seizures do they use surgery to treat? Is it any type of seizure or just the more, I guess noticeable seizures like tonic-clonics? Sorry if I sound really ignorant, its probably because I am about this lol!

 

[walkerjm3]

It depends on what is causing them. If you have a tumor, lesion, or sclerosis on your brain that is most likely the cause, that's when surgery is considered. It can be for any type of seizure, but it's when they're uncontrolled.

 

[Nakamova]

Meds are usually the first line of treatment, but if they don't work then surgery is considered. In order for surgery to be an option, the seizures have to originate in identifiable localized regions of the brain that are safe to remove. (They can't just nip and tuck throughout the brain). Often the surgery is a lobectomy -- removing part or all of the temporal lobe region. Not everyone is a good candidate for surgery, and surgery isn't always successful, but in the last few decades it's become a more viable treatment option as brain-scanning technologies have improved.

 

[Belinda5000]

surgery doesn't always stop the seizures brain surgerycan also start seizures when you have it done for something else.
My husband had surgery in 1972 and never had another seizure they removed a white mass in his Left temporal lobe.I've known people who had it in the 199o's and later who are still having seizures. I had surgery in 1982 RTL it didn't work for me.:twocents::e:

 

[Cint]

Meds are usually the first line of treatment, but if they don't work then surgery is considered. In order for surgery to be an option, the seizures have to originate in identifiable localized regions of the brain that are safe to remove. (They can't just nip and tuck throughout the brain). Often the surgery is a lobectomy -- removing part or all of the temporal lobe region. Not everyone is a good candidate for surgery, and surgery isn't always successful, but in the last few decades it's become a more viable treatment option as brain-scanning technologies have improved.

Nakamova is right. The lobectomy is a last resort. I had mine done on my left temporal lobe after trying numerous meds, to no avail. I am one that is in the small percentage that the surgery doesn't work. I was seizure-free for 14 months and then the seizures came back with vengeance. I didn't qualify for a 2nd surgery. The damaged area was too deep in the brain to remove.

Here is more info on the surgeries:

What are the main types of epilepsy surgery?

* The first, and by far the most common, is called resection or resective surgery. In this type, the surgeon removes the area of the brain that causes the patient's seizures. (The name of the specific procedure generally ends with "ectomy," which means removal by cutting.)

The most common type is called a temporal lobectomy, in which part of the temporal lobe of the brain is removed.

The goal of resective surgery for epilepsy is most often cure of the seizure disorder.

*The second, less common type of epilepsy surgery interrupts nerve pathways that allow seizures to spread. The term disconnection is sometimes used to describe it.

One example of this kind of procedure is called a corpus callosotomy. (When you see "otomy" at the end of a word, it means that that thing is being cut.)
A procedure called multiple subpial transections is another example of this type of surgery. This procedure may be helpful when seizures begin in areas that are too important to remove.

*Disconnection procedures are generally thought of as providing relief, but not a cure.

 

[Cint]

It depends on what is causing them. If you have a tumor, lesion, or sclerosis on your brain that is most likely the cause, that's when surgery is considered. It can be for any type of seizure, but it's when they're uncontrolled.

They didn't know what caused my seizures to begin with, but I somehow ended up with a damaged left temporal lobe. Sometimes, if one had meningitis, encephalitis, or any brain damage from falls or even child abuse, all this can cause epilepsy, too. Often times, the cause is unknown, like in my case. And mine was uncontrolled. Now it is considered refractory.

 

[jenagade]

Thank you everyone who has posted here, I appreciate the information. I'm a long way off before we would even discuss the potential of surgery but I find everything seems a bit less daunting with more information.

 

[qtowngirl]

unfortunately surgery is not doable for all types of seizures. as nak said it's considered when one has a seizure focus (one area). for those who only have generalized seizures (tonic clonics, absence, etc.), surgery is not possible because it's a seizure of the entire brain, meaning there is not a focal area to remove.
surgery is mostly considered for those who have partial (simple or complex or both) seizures, as this means the seizures are coming from one area. sometimes these turn into tonic clonics, but not always and not for everyone.

we're talking about this in another recent thread, it's also true that surgery isn't by standard a 'last ditch effort.' myself and a girlfriend of mine (2ndchances on here) went from meds not working to seizures getting worse to the surgery table, neither of us tried or were asked to try other options such as the vns. depends alot on one's epilepsy team.

 

[Cint]

When I had my Temporal Lobe surgery back in 1990, there was NO VNS nor were there many AEDs on the market, so for me the surgery was a last resort for seizure control. I had tried all the drugs on the market at the time. And since the lobectomy didn't work for me, I did have the VNS surgery when it first became available back in 1997. It works far better for me than brain surgery ever did.