Surgery is an alternative for some people whose seizures cannot be controlled by medications. It has been used for more than a century, but its use dramatically increased in the 1980s and 90s, reflecting its effectiveness as an alternative to seizure medicines. The benefits of surgery should be weighed carefully against its risks, however, because there is no guarantee that it will be successful in controlling seizures.
- People with partial epilepsy who are considered for surgery have difficult-to-control seizures that have not responded to aggressive treatment with medication. In the past, patients usually tried several medications with poor results for many years, even decades, before being considered for surgery.
- More recently, surgery is being considered sooner. Studies have shown that the earlier surgery is performed, the better the outcome.
- Surgery is now being performed on some people whose seizures have been uncontrolled for only 1 or 2 years. At least two single drugs and a combination of two or more drugs should be tried before surgery is considered.
- Epilepsy surgery can be especially helpful to people who have seizures from structural brain problems (such as benign brain tumors, strokes or malformations of blood vessels).
Epilepsy treatment must consider a person's quality of life, not just the number of seizures. Both continued seizures and high doses of medication impose costs on all areas of a person's life—intellectual, psychological, social, educational, and employment.
- Both medical and surgical approaches should be individualized to consider these factors when weighing the benefits of seizure control versus the risks of continued seizures and treatment side effects.
- State-of-the-art technology can now be applied to perform the safest and least-invasive procedure that will help each person to achieve the highest possible quality of life.