Epilepsy Surgery

Epilepsy surgery treats drug-resistant seizures by removing or disconnecting seizure-generating brain tissue or modifying the networks that spread seizures.

Anterior temporal lobectomy: An operation that removes the front portion of the temporal lobe, usually including seizure-generating tissue. This established resection can stop seizures arising from a localized temporal-lobe focus.
Drug-resistant epilepsy: Epilepsy in which adequate trials of two tolerated, appropriately chosen antiseizure medicines fail to achieve sustained seizure freedom. This is the main clinical reason to consider surgery.
Mesial temporal lobe epilepsy: Focal epilepsy arising from structures deep within the temporal lobe, especially the hippocampus and amygdala. It is a common setting for surgery when seizures resist medication.
Antiseizure medication: Medicine used to reduce the likelihood or severity of epileptic seizures. Medication is tried first; surgery is considered when adequate drug trials do not control seizures.
Selective amygdalohippocampectomy: An operation that removes the amygdala and hippocampus while sparing much of the surrounding temporal lobe. It targets mesial temporal seizure sources while limiting removal of lateral temporal tissue.
Epileptogenic zone: The brain region whose removal or disconnection is necessary to produce seizure freedom. Surgery aims to treat this inferred zone, which cannot be measured directly.
Hippocampal sclerosis: A pattern of hippocampal neuronal loss and scarring associated with temporal-lobe epilepsy. It is a frequent imaging and pathology finding in temporal-lobe surgical cases.
Ketogenic diet: A high-fat, low-carbohydrate diet that can reduce seizures in some people with epilepsy. It is a non-surgical treatment option, particularly for some difficult-to-treat childhood epilepsies.
Corpus callosotomy: A disconnection operation that cuts some or all fibers connecting the brain's cerebral hemispheres. It can reduce seizure spread between hemispheres, especially in drop attacks.
Presurgical evaluation for epilepsy surgery: A coordinated assessment using clinical, imaging, and electrophysiological evidence to determine surgical options and risks. It tests whether seizure onset can be localized and treated safely.

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