Surgical techniques usually involve removal of affected brain tissue. Since the advent of MRI, small local abnormalities, such as those known as cavernous angiomas, low grade astrocytomas, and cortical dysplasias, have been identified. Often these areas can be removed and epilepsy cured using a procedure called lesionectomy. The most common surgical procedure is temporal lobectomy, which is performed when epilepsy occurs in the temporal lobe and involves removing small portions from the hippocampus. Appropriate candidates for surgery usually have complex partial seizures that began when they were between 5 and 10 years old, which often went into remission during childhood, but which became intractable in adolescence and young adulthood.
Complications are rare.
In a few cases, patients may experience some memory loss or language difficulties after the operation. Detrimental changes in personality, emotions, or behavior are uncommon. Other surgical procedures called hemispherectomy and corpus callosotomy offer hope for infants and young children with catastrophic seizures that occur in one or part of a hemisphere and for patients whose seizures are due to certain structural brain abnormalities or tumors. Surgery can end drop attacks in patients who suffer from secondary generalized epilepsy with diffuse brain damage, such as in Lennox-Gastaut syndrome. Vagus Nerve Stimulation Electrical stimulation of the vagus nerve, the longest nerve in the body, is proving to be an effective treatment for epilepsy in many cases.