Treatment for people with epilepsy usually begins with medications. But for some people, medications aren’t enough to control seizures. Epilepsy surgery is a safe, effective option that can bring you relief.
At Henry Ford Health, our skilled neurosurgeons have experience in the most advanced open and minimally invasive procedures to treat epilepsy in adults. We use the latest technologies, such as brain mapping and robotic equipment, to plan delicate procedures in this most sensitive area.
What is epilepsy surgery?
In epilepsy surgery, our neurosurgeons perform surgical procedures to treat areas of the brain where seizures occur, known as the seizure focus. The goal is to remove the seizure focus to stop or reduce seizures without affecting brain function.
Before epilepsy surgery, your care team meets with you for a thorough evaluation, including testing, to help confirm a diagnosis. The information we gather, including type of seizure and location in the brain, helps us decide whether surgery is right for you. Learn more about our process for epilepsy and seizure evaluation and treatment.
Epilepsy surgery at Henry Ford: Why choose us?
We understand that you’ll have many questions when you come to our Comprehensive Epilepsy Center. Our team listens carefully to what you’re experiencing and addresses your concerns about brain surgery for epilepsy. We help you understand the details of all your treatment options to decide what’s right for you.
Highlights of our epilepsy surgery program include:
- Team approach: Our epilepsy specialists work together in a thorough review of each patient’s case by epilepsy neurologists, neurosurgeons, neuropsychologists, Ph.D. scientists and radiology researchers. Meet our epilepsy team.
- Compassionate care: We understand that epilepsy surgery can be worrisome for you and your family. Our team talks you through the experience, so you’ll know what to expect. We explain the details so that you feel comfortable with your treatment plan.
- National recognition: We’ve received certification from the National Association of Epilepsy Centers (NAEC) as a level 4 epilepsy center. This means we offer the highest level of care and the most advanced surgical techniques for complex epilepsy.
- Intensive pre-surgical testing: In our pre-surgical evaluation, you undergo intensive testing in our comfortable epilepsy monitoring unit (EMU). You receive 24/7, compassionate care from our nurses and other staff to ensure your safety throughout your stay.
Types of surgery to diagnose epilepsy and seizures
Some types of epilepsy surgery help diagnose seizures by providing information about the seizures or nearby healthy areas of the brain. Electrodes placed in or on the brain record electrical activity to show where seizures begin and identify areas of critical brain function.
Robotic-assisted stereoelectroencephalography (S-EEG)
In a minimally invasive procedure, our neurosurgeons use robotic equipment to place depth electrodes, tiny wire probes, in the brain. Using ROSA, or robotic stereotactic assistance, requires only a few small openings in the skull compared with a craniotomy. This robotic procedure shortens the surgery period and helps reduce your pain and recovery time after the procedure.
Craniotomy to place electrodes
Our neurosurgeons place groups of electrodes in strips or grids inside the skull in a craniotomy. The surgeon removes a portion of skull to access the brain and replaces it at the end of the procedure, after placing the electrodes.
Surgery to control seizures
Epilepsy surgery can either remove the seizure focus or help prevent seizures from spreading throughout the brain. Our neurosurgeons offer several types of epilepsy surgery depending on the type of seizures you experience and where they begin in the brain.
Focal resection is surgery to remove the seizure focus, which can be a brain lesion (damaged area) or part or all of a brain lobe. We perform this surgery for people who have seizures in only one area of the brain, and that area can be safely removed without damaging critical brain function.
The corpus callosum is a band of nerve fibers that connects the two halves (hemispheres) of the brain. It helps the hemispheres share information, but it also contributes to the spread of seizure impulses between the hemispheres. A corpus callosotomy is an operation that separates the corpus callosum, stopping the seizures from spreading from one hemisphere to the other.
This procedure involves removing part of a brain hemisphere and disconnecting the remaining tissue from the other hemisphere. Functional hemispherectomy is sometimes used to treat people who have severe seizures involving large areas of the brain.
Laser interstitial thermal therapy (ablation) to control seizures
Our neurosurgeons perform a minimally invasive procedure to access a seizure focus through a small opening in the skull. We guide a laser wire to the seizure focus and apply heat to destroy the brain tissue.
Neurostimulation devices to control seizures
Neurostimulation, or neuromodulation, uses electrical devices that send mild electrical pulses to the brain to stop seizures or prevent them from spreading.
Responsive neurostimulation (RNS)
Our neurosurgeons implant a neurostimulator device under the scalp, flush with the skull, in an opening just large enough for the device. We connect electrodes from the responsive neurostimulation device to the seizure focus and program the device to monitor your brain’s unique electrical patterns. When the system detects unusual activity, it delivers electrical pulses through the electrodes to stop or even prevent a seizure.
Henry Ford participated in the clinical trial for the RNS system. Our team pioneered research that led to its approval by the U.S. Food and Drug Administration in 2013. Through that research, we have extensive experience using RNS with excellent results. Learn more about all of our epilepsy research efforts.
Vagus nerve stimulation (VNS)
Similar to the RNS system, vagus nerve stimulation (VNS) involves a device and electrodes that send electrical signals to reduce seizures. With VNS, surgeons implant an electrode wrapped around the vagus nerve on the neck and connect it to a pacemaker in the chest.
Your care team programs the VNS device to send electrical pulses at specific levels and intervals. You can also use a magnet to turn the device on and off.
Deep brain stimulation (DBS)
Henry Ford is a leader in deep brain stimulation (DBS) surgery, and our neurosurgeons have extensive expertise in this procedure. In this procedure, your surgeon implants electrodes in the brain to deliver controlled electrical impulses to help control epilepsy. Learn more about deep brain stimulation and read one of our patient stories about a young man’s experience with the procedure.
Medications for epilepsy and seizures
For about two-thirds of people who have epilepsy, anti-epileptic, or anti-seizure, medications can control seizures without the need for surgery. Learn more about epilepsy and seizure medications that we prescribe.
Is epilepsy surgery right for me?
While surgery can help many people with epilepsy and seizure disorders, it is not an answer for everyone. If medicines have not helped to alleviate your seizures, our specialists will evaluate you to determine if surgery may be an option. During your evaluation, you may stay at one of our monitoring units periodically. The evaluation process typically takes between a few months to a year to complete.
Epilepsy surgery: Success rates
More than 80 percent of patients with temporal lobe epilepsy (the most common form of epilepsy) gain complete control of their seizures after surgery. Most of the remaining 20 percent of people report significant improvement in their symptoms and quality of life.
For patients with seizures caused by brain tumor or scar tissue, surgery to remove the tumor (or identified tissue) eliminates the seizures in most cases.