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Preparing for Neurosurgery for Epilepsy

Last updated: May 2023

Neurosurgery may be a doctor's recommendation after trying multiple medications but seizures are still happening often, particularly if it's more than once per day. A lot of progress has been made in both neurosurgery and implants for epilepsy.

I don't remember much from my first neurosurgery that took place in 1997, at the age of 8. All I know is it was done at a hospital and it barely helped my seizures.

Finding the location of seizures in my brain

A second brain surgery was recommended by a doctor when I was still a fairly young patient. Because of the first outcome, I wasn't jumping for joy, and I had fear. At the age of 12 I understood it more, but had difficulty listening to the neurosurgeon describe what he was going to perform. Therefore, I  sat outside of the office as my parents spoke and listened.

When admitted, I felt prepared for mapping, and truthfully, I was so used to being in the hospital that I was not nervous. This may have actually been an impediment to me having a seizure, because it ended up taking 10 days until a complex partial (now known as focal seizure) occurred. Finally, the neurosurgeons could see where in my brain seizures were happening.

Then it was time for neurosurgery! The location was found! The seizures may have not ended, but progress had been made.

My next neurosurgery for epilepsy

A third neurosurgery was done 9 months later, so it was  bound to work. My bravery grew and I was ready for the third brain surgery. All tests were redone except for the Wada test. I was awake during surgery as a precaution for my brain functions such as speech and memory. So they kept me talking.

I was asked personal questions. The closing question was, "What's your favorite Eminem song?" My response was, "Bitch." Surgically speaking, it was then time to stop. Because the removal was too close to the speech area of my brain.

Did I heal instantly? No, but my seizures decreased, and as time went on my seizures changed more. Change meaning that there has been such a large decrease that I am barely having any today. Some days I wonder if 1 will happen, and if a seizure by chance does happen, it is tiny and I stay aware of what is going on around me. Unlike before – like when I slid myself against the wall when an aura happened and I went unconscious.

Precautions and tests before neurosurgery

Surgically speaking, precautions need to be taken. If a doctor recommends making an appointment with a specific neurosurgeon, make sure the person has enough experience and is well-qualified to take care of your circumstance. Even if the person has experience, it does not mean everything will be done properly. There are also a number of tests before and surgical removal takes place.

Neuropsych evaluation

A neuropsych test is a procedure that is done to see if a patient is eligible to be a surgical candidate by doing a measurement of motor memory, audio memory, attention, processing speed, graphomotor, executive functions, and learning.1

Brain imaging

If the patient is a surgical candidate, then other tests will be done such as a video EEG1, CT scan, MRI, PET scan, and MEG.

Brain mapping

Functional mapping is done to determine the area if it is unknown or to identify areas in a person's brain that controls critical functions like vision, sensation, movement, and language. If it is intractable epilepsy, more tests may need to be done as well as mapping.1

Wada test to avoid complications

Before doing mapping or removal of a location, make sure to find out the probability of damage such as memory impairment, loss of speech, and other damages or symptoms that can be complications of surgery. To avoid such things from happening, a Wada test is done to help the neurosurgeon locate where speech or memory functions are and the percentage in the left and right hemisphere.1

After brain surgery for epilepsy

So be ready for lots of tests and procedures. Patients are usually held in the hospital a few days after the surgery is done, too, to make sure everything went over well. Hopefully a seizure does not occur. Try to be prepared and brave.

Do not be angry at yourself or give up if your seizures remain active or serious. Have faith. As my pediatrician said, "Read everything you can possibly find and learn everything you can learn. Knowledge is power." 

Seeing my epileptologist for such a long period of time, I trust him and listen to advice he gives me. Believe in yourself and be able to believe in your doctor. Have faith and try to not have fear in regard to surgery even though it could be difficult to face.

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