Epilepsy is a neurological disorder characterized by recurrent seizures, which can significantly impact a person’s quality of life. While medications help many patients manage their symptoms, some individuals continue to experience seizures despite trying multiple drug therapies. For these patients, surgical intervention, such as a craniotomy, may offer a path to better seizure control.
What is a Craniotomy for Epilepsy?
A craniotomy is a surgical procedure that involves temporarily removing a portion of the skull to access the brain. In epilepsy surgery, the goal is to remove or modify the area of the brain responsible for generating seizures while preserving essential functions like movement and speech.
Who is a Candidate for Epilepsy Surgery?
Surgical treatment is considered for epilepsy patients who:
- Have focal epilepsy, where seizures originate from a specific brain region.
- Do not respond to anti-epileptic drugs (drug-resistant epilepsy).
- Experience seizures that significantly impair daily life, including work, education, and social interactions.
- Undergo pre-surgical evaluations, including imaging and electrophysiological studies, to pinpoint the seizure focus.
Types of Epilepsy Surgery Involving Craniotomy
There are several surgical techniques used to treat epilepsy, depending on the seizure focus and the patient’s neurological function:
- Temporal Lobe Resection: The most common epilepsy surgery, particularly for mesial temporal lobe epilepsy (MTLE). It involves removing part of the temporal lobe, which is often the source of seizures. This procedure has a high success rate, with many patients achieving complete seizure control.
- Lesionectomy: Used when seizures are caused by a specific brain lesion, such as a tumor or malformed tissue. The lesion is surgically removed, often leading to significant seizure reduction.
- Cortical Resection: A portion of the cerebral cortex is removed to eliminate the seizure focus. This is used for cases where seizures originate from a well-defined, non-essential brain region.
- Multiple Subpial Transections (MST): Instead of removing brain tissue, small cuts are made in the cortex to disrupt seizure activity. This is used when the seizure focus is in a critical area that cannot be removed.
Risks and Benefits of Craniotomy for Epilepsy
Benefits:
- Significant reduction or elimination of seizures in many cases.
- Improved quality of life, including greater independence and reduced medication dependence.
- Lower risk of seizure-related injuries and complications.
Risks:
- Potential complications include infection, bleeding, and neurological deficits.
- Not all patients achieve complete seizure freedom, though many experience substantial improvement.
- Recovery may take several weeks, with ongoing monitoring and rehabilitation.
Recovery and Post-Surgical Care
After surgery, patients typically undergo:
- Hospital monitoring to assess early recovery.
- Follow-up evaluations, including EEG and imaging, to track progress.
- Physical and occupational therapy if needed.
- Adjustments in medication as seizures decrease or resolve.
Finding Expert Care at IGEA Brain, Spine, Pain & Orthopedics
At IGEA Brain, Spine, Pain & Orthopedics, our team specializes in comprehensive epilepsy care, offering advanced diagnostic and surgical treatment options. If you or a loved one has drug-resistant epilepsy, a craniotomy could be a life-changing solution.
