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Epilepsy Surgery

As a Level 4 Epilepsy Center, the epilepsy surgery program at Harper University Hospital offers expertise in diagnosis and management of all forms of epilepsy, and can provide advanced treatments using both medical and surgical approaches. Neurosurgeons at Harper work closely with neurologists, neuropsychologists, neurophysiologists, and neuroradiologists with special expertise in the evaluation of patients with seizure disorders.

An extensive evaluation and testing process is required to determine the part of the brain responsible for the seizures and to assess the appropriateness and impact of surgical intervention. If pre-surgical evaluation suggests that surgery may be beneficial, patients may undergo one of the following procedures:

  • Selective amygdalo-hippocampectomy: Selective removal of the medial temporal structures. This operation is offered to patients with mesial temporal sclerosis.
  • Anterior temporal lobectomy: Removal of the anterior temporal lobe including the medial temporal structures.
  • Extratemporal resection: Removal of epileptogenic cerebral cortex outside the temporal lobe.
  • Functional hemispherectomy: Functional disconnection of the hemisphere in patients with severe unilateral damage and intractable epilepsy.
  • Corpus callosotomy: Sectioning of the corpus callosum to disconnect the two hemispheres and prevent the spread of seizures from one hemisphere to the other. This remains an effective operation for patients with generalized tonic clonic seizures or drop attacks whose seizures are poorly localized with EEG.
  • Multiple subpial transection: Transection of the cortex without removal when the epileptogenic zone is in a functionally important area such as the motor and language areas.
  • Vagal nerve stimulation: Implantation of a stimulating electrode around the left vagal nerve and attaching it to a pulse generator which is implanted under the skin just below the collar bone. This operation is typically offered to patients with complex partial epilepsy poorly localized with EEG.