Epilepsy brain surgery - children

Contents 

Introduction
Referral to a specialist centre
Tests before epilepsy brain surgery
Types of epilepsy brain surgery
What happens during epilepsy brain surgery
After epilepsy brain surgery
Success rates for epilepsy brain surgery
Risks of having epilepsy brain surgery
Other types of epilepsy surgery
Further information and support

Introduction

In England, around 400 children each year could benefit from epilepsy brain surgery. However, in recent years, only around 100 children each year have had surgery on their brain to try to treat their epilepsy.
From November 2012, following a successful campaign by Epilepsy Action, a new Children’s Epilepsy Surgical Service (CESS) will provide epilepsy brain surgery for many more children with epilepsy in England. The CESS is being provided through these four CESS centres.

• Birmingham Children’s Hospital 
• Frenchay Hospital, Bristol
• Great Ormond Street Hospital for Children (GOSH), partnered by Kings College Hospital, London
• Liverpool’s Alder Hey Children’s Hospital with Central Manchester University Children’s Hospital

These centres will treat children from all over England, not just those in their local area.

Epilepsy brain surgery is done to help to stop a child’s seizures, or reduce the number of seizures they have. This information looks at which children might benefit from epilepsy brain surgery. It also looks at the tests a child might have, types of surgery and where to find further information.

Referral to a specialist centre

The National Institute for Health and Clinical Excellence (NICE) is part of the NHS. It is the independent organisation responsible for providing national guidance on treatments and care for people using the NHS in England and Wales. The guidance is to help healthcare professionals, patients and their carers to make decisions about treatment and healthcare.
NICE says that children with epilepsy should have regular reviews of their epilepsy and treatment. At their review, children in any of the following groups should be referred to a specialist centre for re-assessment of their epilepsy. At this point, they may be considered for epilepsy brain surgery.

• Children with behaviour problems, or who have lost any skills they previously had
• Children with an epilepsy syndrome 
• Children under two years of age 
• Children who have not had their seizures controlled within two years of the diagnosis of epilepsy
• Children who have tried two epilepsy medicines in the correct doses but are still having seizures
• Children who have unacceptable side-effects from their epilepsy medicines
• Children who have some abnormality seen on a brain scan 
• Children who have psychological or psychiatric conditions
• Children who have no clear diagnosis of their seizure type or epilepsy syndrome
• Children with Sturge-Weber syndrome 
• Children with Rasmussen’s syndrome (also called Rasmussen’s encephalitis) 
• Children with hypothalamic hamartoma
• Children with hemispheric syndromes (syndromes that affect one half of the brain)

Epilepsy Action has more information about treatment for epilepsy