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Neurosurgical Treatments for Epilepsy


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Neurosurgical treatments for epilepsy can reduce the frequency or intensity of seizures —and sometimes even stop them entirely. Most procedures involve removing the area of the brain where seizures take place or implanting a device in the brain. However, neurosurgical treatment is not without risks, and it’s not for every patient with epilepsy.

At the University of Miami Health System, our expert neurosurgeons use the latest surgical techniques to treat epilepsy. We work with you to determine if surgery could help improve your health and quality of life.

Who is a Candidate?

New surgical options are available for almost every patient who has severe intractable epilepsy.

You may be a candidate for neurosurgical treatment if your epilepsy:

  • Causes severe seizures that impact your quality of life and cannot be controlled by medicines. You must have tried at least two anti-seizure medicines without success to qualify for surgery.

  • Is caused by an injury or malformation in an area of your brain that can be removed surgically.

What to Expect

We offer advanced neurosurgical treatments for epilepsy. Your doctor will help you determine which treatment may be the most effective for you.

All epilepsy surgeries have risks. After the procedure, you may have trouble with language, memory, or other cognitive skills. Talk to your doctor about the possible risks and benefits of these treatments.

During all epilepsy surgeries, you will be asleep under general anesthesia. Each procedure can take between three and eight hours. You should expect to spend at least one night in the hospital as part of your recovery.

Open Surgery
During open epilepsy surgeries, your surgeon makes an incision through your scalp and creates a hole in your skull called a craniotomy. They locate the area of the brain that causes your seizures, using an electroencephalogram (EEG) monitoring, and remove it.

With all open brain surgeries, you will spend a few days in the hospital recovering. It may take three or four weeks for you to return to your normal activities.

Temporal Lobectomy
This open surgery, which requires an incision through your scalp and skull, is used for people who have seizures in their temporal lobe. This procedure removes the temporal lobe.

Temporal lobectomy is the most successful form of epilepsy surgery. Around 65 percent of patients who undergo this procedure never have another seizure. You will spend a few days in the hospital recovering.

Laser Interstitial Thermal Therapy (LITT)
The LITT procedure is a less invasive way to treat intractable epilepsy. Your neurosurgeon uses magnetic resonance imaging (MRI) to target the area of your brain causing seizures. They then make a small incision in your head and guide a thin, needle-like device into the area.

Once the needle is in place, a laser heats up the area around the tip, destroying the targeted area of the brain and leaving surrounding areas undamaged. Once the area is destroyed, the needle is removed, and the incision is closed. You will have a faster recovery from this procedure than open surgery — most people can return home the next day. In carefully selected cases this procedure may produce seizure freedom rates as high as 65 percent.

A NeuroPace device works like a pacemaker for your brain. The small, battery-powered device is implanted in your skull, with wires that lead from the device into your brain. It’s placed using minimally invasive surgery, which takes about three or four hours.

For about two weeks after your surgery, the NeuroPace device monitors your brain activity and records seizures. Using this data, your doctor can program the device to send an electrical signal whenever it detects an oncoming seizure, which can disrupt and prevent the seizure. In clinical trials, the majority of patients had 50 percent fewer seizures. The device becomes more effective over time and at 7 years, patients may experience up to a 75 percent reduction in seizure frequency.

NeuroPace is most commonly used in adults who experience seizures in different areas of the brain. Recovery from the procedure is faster than open surgery, though you may need to spend a night in the hospital.

The University of Miami health System recently implanted the first new generation NeuroPace device in South Florida.

Why Choose UHealth?

Level 4 epilepsy center designation. As one of the National Association of Epilepsy Center’s designated level 4 epilepsy centers, the International Comprehensive Epilepsy Center at University of Miami Hospital offers the highest level of diagnostic abilities and treatment options to eliminate your seizures. Our multidisciplinary specialists include epileptologists (experts in seizure disorders), neuropsychologists, and other professionals who work together to make sure you receive comprehensive care.

The latest epilepsy treatments. For more than 30 years, our epilepsy experts have been treating individuals with intractable epilepsy (seizures aren’t controlled with medicine). We’ve been active in the development of new techniques, including minimally invasive laser procedures, stereoelectroencephalography (SEEG), responsive neurostimulation using the NeuroPace device, deep brain stimulation, and robotic procedures. Our specialists were involved in the first evaluation of vagal nerve stimulation to treat epilepsy. We continue to develop new approaches in the surgical treatment of epilepsy.

Top-ranked neurosurgery team. Our neurosurgery program is nationally ranked among the best by U.S. News & World Report. We are the leaders in the treatment and diagnosis of neurological conditions. Our knowledge, expertise, and commitment to patient care have earned us our reputation as a world-class research and medical center. That means we provide state-of-the-art treatment as well as superior follow-up care.

Surgical expertise. We see more than 14,000 patients each year and perform more than 4,000 surgeries. Our experienced neurosurgeons are consistently pioneering new treatments. From minimally invasive spine surgeries to awake craniotomies, we offer surgeries you can’t find anywhere else in the region.

Concierge service. Patients don’t have to figure it all out alone at UHealth. You’re assigned a concierge coordinator who is there for you and your family while you’re in our care. They connect you with other providers, walk you through the surgery process, and answer any questions you or your family may have.

Medical and technological advancements. We are on the cutting edge of neurosurgery with advanced technologies like robotics, 3D intraoperative imaging, and deep brain stimulation. As a patient at UHealth, you also have access to the innovative research and the latest clinical trials. You can count on getting the very best in neurological surgery and care.

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