These pages are about surgery in the UK. If you are looking for information about surgery in another country, please contact your local epilepsy organisation.
There are many different types of epilepsy brain surgery. The type your child might have depends on their type of seizures, and where the seizures begin in their brain. Here are some of the more common types of epilepsy surgery.
This is done when surgeons know which part of the brain the seizures start in. Children having this type of surgery have a small part of their brain removed. Although this sounds worrying, the surgeon will only take away damaged parts that aren’t needed.
If the part of the brain causing the seizures is in the temporal lobe, the surgery is called a ‘temporal’ resection. If the part of the brain causing the seizures is in one of the other lobes, it is called an ‘extra-temporal’ resection.
Multiple subpial transection
This surgery is only rarely done. It is done when it is not possible to remove the part of the brain that is causing the seizures. The surgeon will make a series of cuts to separate the damaged part of the brain from the surrounding area. This stops seizures moving from one part of the brain to others.
During this surgery the 2 hemispheres (halves) of the brain are separated. It is mainly used for generalised seizures, particularly frequent drop attacks, (tonic and atonic seizures), and myoclonic seizures that affect the whole body. It is also used for severe focal seizures that start in one hemisphere and spread to the other.
Hemispherectomy / hemispherotomy
This is major surgery to remove or separate (disconnect) one half of the outer layer of the brain from the other. It is for children who have seizures as a result of one half of their brain being badly damaged or not working properly. Removal of one hemisphere is called ‘hemispherectomy’. Sometimes the hemisphere is not removed, but completely disconnected from the rest of the brain. This is called hemispherotomy.
What happens before, during and after epilepsy brain surgery?
What happens during surgery will depend on the type of surgery the child is having.
Your child will be very carefully prepared for surgery in the operating theatre. They will be put to sleep with a general anaesthetic. Altogether, this part of the operation may take up to 2 hours.
Most children will have a small cut made in their skull, so that the surgeon can see their brain. The surgeon may then remove some bone. On rare occasions, and only usually in children older than 12 years, the surgeon may wake the child up during part of the operation. It is done so that they can find the part of the brain that controls language and movement. The surgeon will explain to your child why this happens. Afterwards, the bone is replaced and fixed to the skull for healing
Most epilepsy brain surgery takes at least 4 to 6 hours, and sometimes longer.
If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.
Epilepsy Action wishes to thank Dr Richard Appleton, consultant paediatric neurologist at Alder Hey Children’s Hospital, Liverpool, UK, for his contribution.
Richard Appleton has no conflict of interest.
This information has been produced under the terms of The Information Standard.
- Updated May 2016To be reviewed May 2019