Epilepsy Surgery

Epilepsy Surgery

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If your seizures are severe and are not controlled with medication, you may be a candidate for epilepsy surgery. If the seizure focus, the area where your seizures originate, can be determined and destroyed or removed, the chance of eliminating seizures altogether is higher with surgery than with other treatment methods. With any of these options, the goal is to stop or lessen seizures while protecting vital areas of the brain.

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Epilepsy Surgery at Duke University Hospital
Find the information you need to prepare for your epilepsy surgery.

Epilepsy Surgery Types

Most epilepsy surgeries require inpatient monitoring beforehand and a four- to five-night hospital stay afterward, plus additional recovery time at home. The most common surgical procedures we use to treat epilepsy include:

Anterior Temporal Lobectomy
Removes a portion of the brain’s temporal lobe, the most common area for seizure activity to start. This approach has a high success rate for long-term seizure freedom.

Resection of Seizure-Causing Lesions or Scars
Removes tumors, vascular malformations, or developmental abnormalities that can cause seizures.

Cortical Resection
Removes brain tissue outside of the temporal lobe that is a source of seizure activity.

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Removes portions of one half of the brain (a "hemisphere") where seizures occur and disconnects the brain’s two hemispheres. As a result, seizure activity cannot spread from one half of the brain to the other.

Corpus Callosotomy
Typically used in younger adults who experience dangerous falls during seizures. Similar to a hemispherectomy, neurosurgeons disconnect the brain’s two halves to stop seizures from spreading from one side to the other. 

Laser Interstitial Thermal Therapy (LITT)
A minimally invasive, MRI-guided procedure. Neurosurgeons drill a small hole in the skull and thread a laser to the seizure focus. The heated laser burns away the part of the brain where seizures begin. Because this procedure is less invasive than other epilepsy surgeries, you’ll only need to remain in the hospital for a couple of days before returning home.

Implantable Devices

Implantable neurostimulation devices are another surgical option. If medications or treatments haven’t provided satisfactory relief and other surgeries aren't ideal for you, these devices can help prevent or interrupt seizures. Once implanted, these devices aren't noticeable or bothersome and can remain in place for your lifetime.

Vagus Nerve Stimulator (VNS)
A pacemaker-like device or battery is implanted under your collar bone. A wire connects it to the left vagus nerve in your neck, which is connected to your brainstem. On a schedule, the device delivers weak electrical pulses to the brain that help prevent seizures. A handheld magnet allows you to activate the stimulator (for example, if you sense a seizure is imminent) or deactivate it. The procedure to place a VNS can be performed on an outpatient basis, meaning you'd be able to go home that same day. Our epileptologists also offer investigational VNS trials to test new ways of programming the device to detect seizures before they happen.

Responsive Neurostimulator (RNS)
An RNS works like a pacemaker for the brain. It is implanted into your skull and connects to electrodes placed directly on or in the brain. It monitors your brain activity and identifies abnormal patterns that could lead to a seizure. Then it sends small electrical shocks to prevent or interrupt seizures. 

Deep Brain Stimulator (DBS)
A pacemaker-like device is implanted under your collar bone that transmits electrical signals through two small wires to targeted areas of the brain. These signals are delivered on a schedule and help stop seizures from beginning or spreading.

Need a Second Opinion?

Our experts can review your records and contact you to discuss an effective treatment plan. Please call 919-385-3223, and our patient navigator will help make arrangements for your second opinion.

Why Choose Duke

Experienced, Compassionate Care
Our epileptologists are board-certified experts with years of experience treating people with difficult-to-control epilepsy. Our neurosurgeons embrace new technology as surgical options evolve to become less invasive and more precise.

Technology Designed for Safety
Our epilepsy and neurointensive care units have an electroencephalogram (EEG) machine and video-recording capabilities in every room. This allows our staff to monitor your brain’s electrical activity 24 hours a day. In addition, we have two operating rooms equipped with magnetic resonance imaging (MRI) scanners to assist with the most challenging procedures. This allows surgeons to see your brain in intricate detail in real time.

High-Volume Epilepsy Center
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. On average, Duke performs more than 50 neurostimluator implantations, 20 intracranial monitoring procedures, and 20 resective surgeries (those that remove tissue or part of an organ) in adults each year.

Duke University Hospital is nationally ranked in 10 adult specialties
Level 4 Epilepsy Center
As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical and surgical treatments for people with epilepsy. It is one of the reasons why Duke University Hospital is nationally ranked in neurology and neurosurgery and ranked first in North Carolina by U.S. News & World Report.
Reviewed: 07/12/2019