You are a candidate because your seizures have not been controlled with medication, and we have determined where your seizures begin and that surgery would not pose a significant risk to you.
What are the different kinds of seizure operations?
Frequently, seizures originate from the temporal lobe because it is an area in the brain very susceptible to injury. An operation called a temporal lobectomy removes part of that region in order to control the seizures.
Seizures begin in other regions of the brain less frequently. After determining that it is safe, these epileptic regions often can be removed.
A third type of operation is called the corpus callosotomy. In this surgery, the front connections between the two halves of the brain are severed. This prevents seizures from spreading from one half of the brain to the other. Although the seizure region is not removed, the seizures remain small and falling seizures are reduced in number.
Will it stop my seizures completely?
The percentages vary depending on your individual case and the type of surgery you have. Your doctor will discuss your case with you individually.
What are the risks of surgery?
Complications include a very small risk of paralysis of an arm or leg and loss of vision on one side. You may also develop an infection resulting in a stiff neck and some confusion that will clear with treatment. Side effects from surgery include temporary problems resulting from brain swelling after surgery. The swelling may produce a mild weakness of an arm or leg, difficulty with finding the right words, and loss of a tiny part of your field of vision. These symptoms get better as the swelling is reduced. In approximately 25 percent of patients, psychiatric symptoms may occur. These symptoms can include depression, hypomania (a state of increased anxiety) and hallucinations. These symptoms can occur anytime within the first several weeks after surgery. Hallucinations usually occur right after surgery and before you are discharged home. The depression and increased anxiety can occur anytime within the first several months after surgery. All of these symptoms are temporary and respond well to treatment.
How long does surgery last?
Approximately five hours.
Will I be asleep during surgery?
Usually you will be asleep, although in certain situations your doctors may ask you to remain awake (but sedated) for a portion of the operation.
How will I feel after the surgery?
You will have a headache for several days and may be nauseated. Some patients complain of neck and backaches as well. You may have a black eye and facial swelling. You should feel much better by the third day and feel ready to go home by the fifth to seventh day.
What problems could I have right after I go home?
Sometimes people find that their emotions go up and down over the first few weeks to months after surgery. Some people may become "blue" or depressed, others excited or elated. The symptoms are temporary but may require a brief course of mood stabilizing medication.
Will I have any long-term problems after surgery?
Your doctor will be able to tell you what the risk is for you. Some people may experience problems with some aspects of memory after surgery, but this is usually only noticed with sophisticated memory testing. Most patients feel better and not as lethargic, as their level of medication may not be as high.
Will I ever be off medication?
If you choose, we will attempt to withdraw your medication two to five years after temporal lobectomy surgery. Longitudinal studies are being conducted to determine the risk of seizure recurrence once medications are stopped. At this time we are unable to tell you how likely it is that you will have a seizure if your medications are stopped.
Will I be able to drive after surgery?
This decision is made by the Department of Motor Vehicles, but most patients have their license reinstated within twelve months after the surgery, as long as you remain seizure free.
Will my musical abilities or special talents be lost?
Will my hair grow back?
Yes. Your hair grows approximately half an inch per month and will remain the same color and texture. The scar will be hidden by your hair.
Will there be a change in my thinking process?
Will there be a change in my personality?
When can I go back to work?
We usually encourage people to tell their employers that they can return to work six to eight weeks after surgery.
What can I do after I go home?
You should take it easy, go for a few short walks and build yourself up slowly. No heavy exercise, and no lifting. Once you are home, if you have any problems or questions please call us. Do not wait for your visit to the doctor. Make sure you schedule a return visit to see the neurosurgeon and the neurologist in two weeks. The postoperative care and testing is a very important part of your evaluation and treatment. For this reason, we will need to see you three months, six months, and one year after your surgery, and annually thereafter. Neuropsychological testing will be done one year after surgery.
Anything else I should know?
At the Columbia Comprehensive Epilepsy Center, we are dedicated to improving our understanding of epilepsy and our ability to treat seizures. You will probably be asked by some members of the epilepsy team to participate in studies being conducted at the Center. You are free to participate in these studies or not, as you wish. You can be assured that every member of the team is devoted to delivering the highest quality of care.