Epilepsy Surgery
Patients who cannot be successfully managed with medical therapy may be surgical candidates. At UCSF, we perform a wide variety of surgical procedures for adults and children that may result in control of seizures.
Diagnostic Studies
Neurosurgeons perform diagnostic studies with intracranial EEG electrodes to localize epileptic foci. The electrodes may be in the form of grids, depth electrodes, or subdural strip electrodes and are used to map electrical activity as precisely as possible.
Focal Brain Resection
Focal brain resections are the most common surgical approach for treating epilepsy and provide the best chance for patients to gain complete seizure control. Types of focal brain resections include:
· Temporal lobectomy
· Lobar resection (frontal, parietal, occipital)
· Topectomy
· Hemispherectomy
Disconnection Operations
Disconnection operations aim to disrupt the abnormal electrical activity that occurs in the brain and triggers epileptic seizures.
· Corpus callostomy — a palliative surgical procedure that is useful for stopping atonic and tonic seizures.
· Multiple subpial transections — used to separate cortical fibers without disrupting main cortical function. This procedure is employed when epileptic foci are located in eloquent cortex because it does not require tissue to be removed.
Vagus Nerve Stimulation
A vagus nerve stimulator is an implanted device that sends regular electrical pulses through the vagus nerve to the brain in order to potentially reduce the onset or frequency of seizures. It can be used to treat a wide variety of adult and pediatric seizure disorders that are not amenable to treatment by other surgical techniques.
Gamma Knife® Radiosurgery
Radiosurgery is most often used to treat seizures caused by hypothalamic hamartomas in adults and children (gelastic seizures). UCSF uses the most current model of the Gamma Knife units, the Perfexion®.
UCSF is currently involved in a Phase III trial using Gamma Knife radiosurgery to treat temporal lobe epilepsy. To find out more about the Radiosurgery or Open Surgery for Epilepsy (ROSE) trial, call (415) 353-2241.