Epilepsy is one of the most common neurological disorders and can severely reduce a person’s quality of life. If your seizures can't be controlled with medication alone, your doctor might suggest epilepsy surgery as the next step.
At Banner Health, our epilepsy specialists and neurosurgeons use advanced imaging, testing and surgical techniques to determine whether surgery is right for you and which treatments offer the best chance of success.
Epilepsy surgery is a treatment that can help reduce or stop seizures or make them less severe. The surgery includes several types of procedures that treat seizures by removing, disconnecting or changing the abnormal electrical activity in the part of the brain that causes them.
The type of surgery depends on:
Because every person’s epilepsy is different, it's important to talk with your care team to see if surgery might help you. Your team will suggest the best pathway to explore treatment options that could help you the most while keeping risks low.
Anti-seizure medications are usually the first treatment for epilepsy. They help control seizures by reducing abnormal electrical signals in the brain.
Epilepsy surgery works differently. It targets the part of the brain where seizures begin and stops seizure activity from spreading to other areas.
Having surgery does not always mean you can stop taking medicine. Some people keep using their medication after surgery, while others might reduce or stop it over time with help from their care team.
Learn about treatment and care of epilepsy.
Many people can effectively manage their seizures with medication alone and without needing surgery. But about one-third of adults and children continue to have seizures despite taking medicines.
If your seizures continue despite trying appropriately chosen medications at proper doses, you may have drug-resistant or medically refractory epilepsy.
Talk to an epilepsy specialist if:
Getting a surgical workup or evaluation doesn’t mean you’ll need surgery. It's just the first step in helping your care team understand if surgery or other treatments are the safest and most effective options.
For those who qualify for surgery, research shows that having the operation earlier in the disease often leads to better control of seizures than waiting.
Your care team will do a thorough evaluation before recommending surgery. This process may take days or weeks and usually involve several tests. Most of the testing is done on an outpatient basis. These tests might include:
Learn more about epilepsy testing and diagnosis.
There are many types of epilepsy surgery. Your procedure depends on where your seizures start and the safest way to treat them.
The surgeon removes the small area of brain tissue where seizures begin while leaving healthy tissue untouched. This is most often considered for people with focal epilepsy.
This is one example of resective surgery. The temporal lobe is the most common region in the brain where seizures begin. Removal of the small area of the temporal lobe that causes seizures can result in good seizure control in carefully selected people with this type of epilepsy.
Laser interstitial thermal therapy (LITT) is a minimally invasive option for some people. Instead of a larger incision or opening in the skull, the surgeon inserts a thin laser fiber through a smaller incision. MRI guidance helps direct heat energy precisely to the seizure-causing tissue while protecting nearby healthy brain tissue.
This procedure disconnects the nerve fibers that allow seizures to spread between the two sides of the brain. It can be helpful to treat dangerous drop attacks and severe seizures, especially in children.
These procedures are typically performed on children or adults with severe epilepsy affecting one entire side of the brain. Rather than removing an entire hemisphere, modern techniques involve disconnecting the abnormal side from the healthy side while preserving as much brain tissue as possible.
Sometimes removing the abnormal brain tissue isn’t a safe, possible option. In these cases, implantable devices can help reduce seizures by altering the brain’s abnormal activity. Options include:
If you have drug-resistant epilepsy, surgery can often help control seizures and improve your quality of life. Depending on your seizure type, where seizures start and the type of procedure, some people even become seizure-free.
Like any brain procedure, epilepsy surgery also carries risks. These may include:
Your care team will carefully review your test results, overall health and seizure history to help determine whether surgery is a good option for you.
Epilepsy surgery can help reduce or, in some cases, stop seizures and improve your quality of life. How well you recover depends on your health, the type of surgery and how your brain responds to treatment.
After surgery, you'll have regular visits with your epilepsy care team. Your surgeon and neurologist will check your recovery, track your seizures and change your medications if needed. Many people stay on anti-seizure medicine after surgery, even if seizures get better.
As you heal, you can slowly get back to your normal activities. This may include work, school, exercise and hobbies. Your care team will tell you when it's safe to do certain things (like driving) again.
While epilepsy surgery can be life-changing, it doesn't guarantee that seizures will stop completely. Some people become seizure-free, while others have fewer or less severe seizures. If seizures continue, your care team can recommend additional treatments to help control them.
If your seizures are not controlled with medication or affect your daily life, Banner Health can help you explore your treatment options. As a nationally recognized center for epilepsy care, our epilepsy care team brings together specialists from neurology, neurosurgery and Banner Brain & Spine to evaluate your seizures and create a personalized care plan.
Our team provides:
We also offer access to clinical trials and advanced treatments that may help reduce seizures and improve quality of life.
At Banner Health, we take time to understand your goals, answer your questions and help you make informed decisions about your epilepsy care.
For some people, surgery completely stops seizures. Others have fewer or less severe seizures. Results depend on the type of epilepsy and where seizures begin.
Epilepsy surgery is generally safe when performed by experienced specialists. Like any surgery, there are risks but your care team carefully evaluates whether the benefits outweigh those risks.
Drug-resistant epilepsy means your seizures continue even after you have tried two or more appropriate anti-seizure medications and treatments. Your doctor may also call this medically refractory epilepsy or treatment-resistant epilepsy.
Most people continue taking anti-seizure medication after surgery. If seizures remain controlled over time, your neurologist may discuss slowly reducing your medication. You should never stop taking seizure medicine on your own without guidance from your care team.
Success varies by procedure and the cause of epilepsy. People with seizures that come from one well-defined area of the brain often have the best outcomes.
Yes. Children with drug-resistant epilepsy may benefit from surgery. Early treatment can sometimes improve their long-term neurological and psychosocial development.
Yes. Some people remain seizure-free for life, while others may have seizures again months or years later. Regular follow-up care helps manage long-term results.
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