Epilepsy surgery may be recommended if your child experiences seizures that cannot be controlled with medications. We understand that you may be concerned about your child undergoing brain surgery. You can rest assured knowing that Duke Health is designated as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers. That means our epilepsy center is staffed by pediatric neurosurgeons who have the experience and expertise to perform advanced operations that may reduce or eliminate your child’s seizures. Some of these procedures are only available at a handful of comprehensive epilepsy centers like ours. Our goal is always to achieve the best possible outcome for your child.

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Implantable Devices

New implantable neurostimulation devices can prevent or disrupt seizure activity in your child’s brain. While the devices are placed surgically, these procedures are usually minimally invasive, so your child may be able to go home the same day.

Vagus Nerve Stimulation (VNS)
VNS therapy is typically considered when epilepsy surgery is not an option. A pacemaker-like device is implanted in the child’s chest during an outpatient procedure. It controls seizures by sending electrical impulses to the vagus nerve, which then sends the impulses to the brain. This device is FDA-approved for children as young as four years old.

Responsive Neurostimulation (RNS)*
A neurostimulator implanted under the scalp is connected to electrodes placed on the surface of or in your child’s brain. This device continuously “listens” for seizure activity from a specific brain region and sends an electrical signal to interrupt seizure patterns. RNS is best for people for whom epilepsy surgery may not be the best option because their seizures originate in an area of the brain responsible for movement, speech, or other important functions.

Deep Brain Stimulation (DBS)*
This newer technology involves placing electrodes in a specific part of the deep brain. The electrodes are connected to a device implanted under the skin of the chest. The DBS sends scheduled electrical signals to deep brain structures to stop seizure episodes. This device may be an option for people whose seizures come from many parts of the brain or in whom resective epilepsy surgery is not an option.

*RNS and DBS devices are FDA-approved for people ages 18 years and older. However, they can also be used in younger children in certain circumstances.

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Epilepsy Surgery

An extensive surgical evaluation will determine if your child is a candidate for epilepsy surgery. 

Focal Cortical Resection

This surgery removes the area of the brain where seizures originate. Studies show it stops seizures in 60% to 80% of children. This method can target any lobe of the brain. It can also treat seizures involving two lobes.

Laser Ablation Surgery

Pediatric neurosurgeons use MRI imaging to guide the insertion of a thin laser that destroys brain lesions responsible for epilepsy and uncontrolled seizures. Because the surgery allows for small incisions, your child will recover faster compared to open brain surgery.

Corpus Callosotomy

When the origin of seizures cannot be identified, this procedure removes a section of a band of tissue called the corpus callosum, which sends messages between the two sides of the brain. This method aims to prevent seizures from spreading from one side of your child’s brain to the other. It is usually performed in people whose seizures cause falls and injuries.


This procedure is recommended for children with very severe epilepsy caused by one hemisphere of the brain that is markedly malformed or injured. It disconnects the parts of the brain causing the seizures. It can resolve seizures in up to 80% of children.

Duke Children’s Hospital & Health Center

Duke Children's Hospital and Health Center provides expert care in a child- and family-friendly environment.

Why Choose Duke

Team Approach to Surgery
Our team works together to determine the best treatment approach for your child. In fact, every child who is evaluated for epilepsy surgery is reviewed by our specialized team during weekly meetings. Our pediatric epilepsy team includes specially trained pediatric neurosurgeons and epileptologists, neurologists, neurophysiologists, neuropsychologists, and more. 

Highly Experienced Center
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. Since our epilepsy center was established in 1982, our neurosurgeons have performed hundreds of brain resections, ablations, neurostimulator implantations, and intracranial electrode implantations to identify seizure focus. 

Level 4 Epilepsy Center - Pediatrics

As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical, and surgical treatments for children with epilepsy. It is one of the reasons why Duke Children’s is nationally ranked in pediatric neurology and pediatric neurosurgery by U.S. News & World Report for 2023-2024.

This page was medically reviewed on 10/13/2022 by