Epilepsy surgery should not be a “last-resort.” Epilepsy surgery is a proven method to improve and potentially completely control seizures in selected patients. Epilepsy surgery is considered in patients who have not had control of their seizures despite trials with 2 or more antiepileptic drugs (AEDs). Epilepsy surgery can dramatically change a patient’s life. The chance of complete seizure control can be > 70% for some patients.
Despite a proven track record, it is typically many years from the time the patient starts having seizures to the time they finally have epilepsy surgery. Studies suggest that patients are finally referred for epilepsy surgery after 20 years of seizure activity. There is mounting data that performing epilepsy surgery sooner rather later may be helpful. Surely, it does not take 20 years to see if 2 or 3 seizure medications are going to control the seizures! Please note- if a patient has not had his or her seizures controlled after trying 2 AEDs, the chances of having AEDs completely control the seizures is quite low. That is why epilepsy surgery is considered in those who have tried 2 AEDs.
Of course, epilepsy surgery has risks. Remember, the surgery involves having the surgeon remove a piece of the skull and removing a piece of brain tissue. This brain tissue is the area of the brain that the seizures were starting. By removing this abnormal tissue, the seizures can be controlled. Risks include stroke, infection or memory problems. With careful evaluation, these risks can be minimized.