After the Surgery: Planning Ahead

Good communication between the doctor and the patient is important with all epilepsy treatment, but especially when surgery is being considered.

Although surgery for epilepsy is more common, more successful and safer than ever before, it is still a major operation.

The patient and the family should therefore have a realistic picture of the benefits, the risks, and the chances of complete or partial control of seizures afterwards.

After the operation, most patients are monitored in an intensive care unit for 24 to 48 hours. Possible complications of surgery include death, bleeding, stroke and infection. Patients may also experience effects because of the areas of the brain that were removed. These may be transient or permanent. All the possibilities should be discussed beforehand. The patient stays a few additional days in the hospital and then goes home to recuperate. After about three weeks he or she can usually resume normal activities.

There may be some physical after-effects of epilepsy surgery. Sometimes there are emotional changes as well. People may feel disappointed if their seizures do not stop completely, or if they have to go on taking medicine, at least for a while, after the surgery.

When seizures stop altogether or happen very seldom, there is an understandable feeling of relief and celebration. But sometimes people also feel depressed. It may be stressful and difficult to meet the new expectations that others may have, or to adjust to being a person without seizures after having them for so long.

In most cases, these reactions are temporary. Like other issues that may arise in connection with epilepsy surgery, they can be handled better if both the patient and the family know what to expect and have talked about them with the multidisciplinary medical team (which may include neurologists, surgeons, nurses, and psychologists) before any operation takes place.