Surgery to Treat Epilepsy

Brain surgery—for example, surgical resection of epileptogenic areas of the brain in patients with partial seizures—sometimes is considered when seizure activity fails to respond to even the most aggressive medical management. Patients considered for these procedures are those with intractable seizures, even when given high levels of anticonvulsant drugs. Video-EEG monitoring on a long-term basis is used to determine where in the brain the seizures occur.

In some patients, placing electrodes beneath the scalp may help to define epileptogenic areas of the brain. Specialized centers throughout the country have multidisciplinary teams to aid in the evaluation of potential candidates for these procedures.

Responsive Neurostimulation

Responsive neurostimulation (RNS) is approved by the U.S. Food and Drug Administration (FDA) to treat adults with partial seizures that

  • do not respond to medications,
  • originate in more than one location in the brain, and/or
  • originate in an important area of the brain.

In this treatment, a battery-powered stimulator is surgically placed into the skull and attached to one or two EEG (electroencephalography) leads that are implanted in the area(s) of the brain where the seizures originate. Responsive neurostimulation directly stimulates the brain to control seizures.

The device detects and stores the brain's EEG and is programmed to send an electrical current when it picks up seizure activity—disrupting the seizure. According to the Epilepsy Foundation®, about 30 to 39 percent of people who have RNS experience a decrease in seizure frequency and/or severity. The procedure is not a cure for epilepsy.

Updated by Remedy Health Media

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 02 Jan 2000

Last Modified: 15 Dec 2014