Surgery for Children

If medicines do not control a child's seizures, he or she may be a candidate for surgery.

The most common form of epilepsy surgery removes a fairly small area of the brain where seizures begin. Sometimes, larger areas are removed.

Other surgery, performed less often, blocks nerve pathways in the brain to stop the spread of seizures from one part of the brain to another.

In rare cases, where there is extensive disease on one side of the brain (such as is found in Rasmussen's syndrome) that is likely to get worse, doctors may recommend an operation to remove most or all of one side of the brain.

In young children the remaining half may take over some of the functions of the half that was removed. However, the child will continue to have weakness and some vision loss on the opposite side.

Brain surgery for epilepsy is not the kind of operation that can be done just anywhere. If your child is being considered for one of these procedures, you will want it to be done in a specialized center by a team of doctors who perform a lot of these operations.

Pre-Surgical Tests

There may be a long period of testing before the surgery is done. Much of it will be to find the precise area of the brain where the seizures begin (called the seizure focus). Tests will also tell the medical team whether surgery on that area can be done without affecting the child's speech, vision, or other vital functions of the brain. Some of these tests may involve surgery to place probes deep in the brain.

While most children who have surgery for epilepsy show improvement afterwards, by no means all become seizure free.

Like other forms of treatment, surgery has risks as well as benefits and you will want to have these carefully explained to you in advance.