Successful epilepsy surgery depends on careful selection of patients and a skilled medical and surgical team.
The operation may take several hours to perform, as surgeons first locate and then remove the area of the brain identified in pre-testing as the source of the seizure activity, or carefully sever the nerve fibers between the two halves of the brain if a split brain operation is being performed, or make the incisions required by the other procedures.
EEG recordings during the surgery help the physicians map out the exact area of brain to be removed.
The brain may be stimulated with mild electrical impulses during the operation itself to identify special areas controlling speech, movement and sensation.
Sometimes the whole operation is done with the patient awake but under local anesthetic. This is possible because brain tissue is not sensitive to pain. This is more commonly done in older patients and adults and less frequently in small children.
After the operation, the patient stays up to a week in the hospital and then goes home and continues to recuperate. After about three to eight weeks he or she can usually go back to normal activities.
Doctors usually recommend that surgery patients stay on anti-epileptic medicines for up to two years after the operation. Some people may have to continue with medication indefinitely to retain seizure control.