When can epilepsy patients be treated surgically?

  Epilepsy is a common disorder with a prevalence of about 1-3%. About 70% of patients with epilepsy can be completely or largely controlled with the right medication. In contrast, nearly 30% of patients with epilepsy cannot be controlled by medication and are referred to as refractory epilepsy. Patients with intractable epilepsy that cannot be controlled with three or more antiepileptic drugs alone or in combination are called “drug-refractory epilepsy”.  Surgical treatment of epilepsy is the removal of epileptogenic foci in the brain or surgery to block the spread of epileptic activity. Surgery can be divided into two categories. One is curative (ending seizures) surgery, such as temporal lobectomy, frontal lobectomy, and hemispherectomy, which is aimed at removing part of the brain tissue (seizure focus) that is causing the seizures. The other type of surgery is palliative (limiting the spread of seizures) surgery, such as corpus callosotomy and vagus nerve stimulation, which is aimed at limiting the spread of seizures and aborting or reducing the seizures that cause physical harm.  Surgery should be actively considered if you have any of the following conditions, but the final decision as to whether surgery is possible or appropriate must be made by a specially trained neurosurgeon  1. The seizures cannot be controlled by medication or there are severe side effects from medication.  2. Partial seizures that always start in the same part of the brain (limited seizure lesions).  3. The seizures significantly affect your quality of life.  4.The cause of the seizure is an injury, such as scar tissue, brain tumor, arteriovenous malformation or birth injury.  5.Seizure discharges spread from local to whole brain.