Neurosurgery and Brain Health 2 Epilepsy Surgery Options for You to Consider By Neurosurgery, April 17, 2018 Epilepsy is one of the most common neurological disorders. In fact, 50 million people worldwide have epilepsy according to the World Health Organization, and about 2 million live in the United States. At least 30 percent of people with epilepsy either don’t respond to treatment with medicine or suffer significant side effects. Those individuals may be eligible for alternative treatments, including epilepsy surgery, but fewer than 3 percent decide to undergo surgical treatment of epilepsy. If you suffer from epileptic seizures and medicines haven’t been working for you, contact the Movement Disorders and Epilepsy Program at UPMC to schedule an evaluation. Epilepsy Surgery Candidates Several surgical treatments are available for epilepsy. The part of the brain where your seizures originate dictates which type of surgery might be appropriate for you. People who have taken two or more medicines with no improvement are potential candidates for epilepsy surgery. Neurosurgeon Mark Richardson, MD, PhD, program director of UPMC Movement Disorders and Epilepsy Program, says the only “cure” for epilepsy is to surgically remove the portion of the brain causing the seizures. People who experience a diminished quality of life, frequent falls, loss of consciousness, or other harmful events due to frequent epileptic seizures should consider surgery. Surgery shouldn’t be a last resort; anyone whose epilepsy isn’t controlled by medicine should be evaluated for surgery. Surgical Options for Epilepsy There are two traditional types of surgery for epilepsy — resection and disconnection — according to the Epilepsy Foundation. Resection surgery involves removing the part of the brain where the seizures originate. In disconnection surgery, the nerve pathways that allow seizures to spread from one part of the brain to another are cut. During a temporal lobectomy, the most common and most successful surgery for epilepsy, a portion of the brain’s temporal lobe is removed. About 60 to 70 percent of patients are seizure-free afterward, according to the Epilepsy Foundation, but may experience side effects such as impaired memory. Technological Advancements Several new surgical techniques used by neurosurgeons to treat epilepsy have resulted in more effective and less invasive procedures, and can produce better outcomes. These include: Laser ablation Laser ablation surgery, a minimally invasive procedure offered at UPMC, uses heat to de-activate the problematic part of the brain, instead of surgically removing it. Patients often leave the hospital the same day. This procedure is less invasive, has a shorter recovery time, and reduces the chances of serious side effects compared to traditional surgery. A study by the American Epilepsy Society shows that people who underwent laser ablation had fewer negative effects on their memory, compared to traditional surgery patients. According to a study published in the journal Epilepsy & Behavior, an impressive 78 percent of people who had laser ablation surgery for epilepsy were seizure-free afterward. Many also were able to return to work and begin driving again. ROSA Robotic Stereotactic Assistance, or ROSA, is a computer system that generates 3-D maps of the brain. ROSA’s robotic arm can then guide the precise placement of electrodes into the brain. In traditional epilepsy surgery, a portion of the skull is removed. With ROSA, small holes are made in the skull. ROSA offers greater accuracy, is less invasive, and takes significantly less time than traditional surgery. If you suffer from epileptic seizures and medicines haven’t been working for you, contact the Movement Disorders and Epilepsy Program at UPMC to schedule an evaluation.