Different Types of Brain Surgery for Epilepsy Explained

Epilepsy is a neurological disorder characterized by repeated seizures. It affects millions of people worldwide. While medication can often manage seizure symptoms, some individuals find relief through surgical intervention.

Among the various surgical choices, brain surgeries show great potential, that’s why in this article we will explore the different types of brain surgery for epilepsy.

Resective Surgery

Resective surgery involves removing the brain tissue responsible for triggering seizures. It is a common option for individuals with focal epilepsy, where seizures originate from a specific area of the brain.

This type of brain surgery for epilepsy aims to eliminate or reduce seizure activity by excising the epileptic focus while preserving healthy brain tissue. Techniques such as lobectomy (removal of a portion of the brain) and lesionectomy (removal of a specific brain lesion) fall under this category.

Temporal Lobectomy

Temporal lobectomy is a specific type of resective surgery primarily used to treat temporal lobe epilepsy, which originates in the temporal lobes of the brain.

This procedure involves removing the part of the temporal lobe where seizures begin, known as the hippocampus and surrounding structures. It has shown high success rates in reducing seizure frequency and improving overall quality of life for many patients.

Hemispherectomy

Hemispherectomy is a more radical form of resective surgery typically reserved for severe cases of epilepsy, such as those associated with extensive brain damage or developmental abnormalities.

In this type of brain surgery for epilepsy, one part of the brain is either partially or completely removed or disconnected from the rest of the brain. Although it comes with risks like problems with movement and thinking, it can transform the lives of people whose severe seizures come from just one side of their brain.

Multiple Subpial Transection (MST)

MST is a specialized surgical technique designed to disrupt the spread of seizures across the brain without removing any brain tissue.

It is particularly useful for patients whose epileptic foci are located in areas critical for language, motor function, or other essential brain functions.

In MST, surgeons create shallow cuts on the brain’s surface to stop the abnormal pathways causing seizures, while minimizing damage to surrounding brain tissue.

Vagus Nerve Stimulation (VNS)

While not classified as a conventional type of brain surgery for epilepsy, VNS represents an alternative surgical approach for managing epilepsy. It involves implanting a small device, similar to a pacemaker, under the skin of the chest with a wire connecting it to the vagus nerve in the neck.

The device delivers regular electrical impulses to the vagus nerve, which then sends signals to the brain, modulating neuronal activity and reducing seizure frequency. VNS is often considered for individuals who are not candidates for resective surgery or have not responded well to medication.

Responsive Neurostimulation (RNS)

RNS is an advanced method for treating epilepsy, employing implanted neurostimulator devices linked to electrodes positioned either on the brain’s surface or within brain tissue.

These devices continuously monitor brain activity and deliver targeted electrical stimulation when abnormal patterns indicative of a seizure are detected.

By precisely modulating neural activity in real-time, RNS offers a personalized and adaptive therapeutic option for individuals with drug-resistant epilepsy, helping to reduce seizure frequency and severity over time.

Conclusion

In conclusion, brain surgeries for epilepsy encompass a variety of techniques tailored to individual patient needs, seizure types, and underlying brain pathology.

While these different types of brain surgery for epilepsy carry risks and require careful consideration, they offer hope for those living with debilitating seizures that have not responded adequately to medication alone.

With ongoing advancements in surgical techniques and technology, the future looks promising for improving outcomes and enhancing the quality of life for individuals affected by epilepsy.