Epilepsy Program: Is surgery right for me?

About 30 percent of people with epilepsy do not experience adequate seizure control while taking anti-seizure medications.

This is called refractory epilepsy. People with refractory epilepsy may be candidates for surgical treatment. The goal of surgery is to stop seizures or reduce their frequency and severity.

While epilepsy surgery has been available for many decades, several new implanted devices and minimally invasive surgical procedures have been developed in recent years that have made surgical treatment of epilepsy an excellent option for some patients, depending on the type of epilepsy they have.

The UCI Health Comprehensive Epilepsy Program evaluates more epilepsy patients than any other program in the region and offers the most advanced surgical treatments available.

Surgical options include:

• Identifying and removing a tiny segment of brain tissue that is generating the seizures
• Implanting devices for brain stimulation that stops seizures

Pre-operative evaluation

Evaluation for surgery is usually recommended if:

• Focal seizures persist even after the person has tried two appropriate medications to control seizures
• There is an identifiable lesion in the brain that is thought to be causing the seizures.

Before surgery, you will undergo tests to ensure that you are a good candidate for the procedure. The pre-operative evaluations are conducted by a multidisciplinary team that includes doctors, nurses, psychiatrists, social workers and technicians.

Tests typically include video EEG monitoring, MRI scans and neuropsychological testing. Doctors may also perform a functional MRI scan or a Wada test, which identifies language and memory functions on the left and right sides of the brain.

Our team also will consider the type seizures you have to determine whether surgery is a safe option.

For example, we will assess whether the seizures are originating in a part of the brain that is responsible for speech, movement or cognition. Then our specialists will discuss with you whether surgery may reduce seizure activity without disrupting normal brain function.

If surgery is recommended, you will first undergo intensive monitoring to pinpoint the precise area in the brain where the seizures are originating.

These tests range from noninvasive EEG monitoring on the surface of the skull to high-tech brain mapping using probes implanted on — or in — the brain to see which areas light up with abnormal electrical activity during seizures. Patients may spend several days in the hospital for around-the-clock monitoring.

UCI Health has a six-bed epilepsy monitoring unit, one of the region's only facilities equipped with highly sensitive instruments able to capture sustained seizure activity within the brain in real-time. 

More treatment options

People who are not candidates for surgery may be prescribed other treatments, such as vagus nerve stimulation or dietary therapies.

Our team strives to find solutions to reduce seizure activity and improve the quality of life of every patient.

Contact us

For more information or to schedule an appointment, call 714-456-6203 or request an appointment online.