Seizure treatment with brain surgery + post-operative care

Seizure treatment with brain surgery + post-operative care

Dr. Mahmoud Yazdan Panahi
Dr. Mahmoud Yazdan Panahi
Tehran

Treatment of seizures with brain surgery Epilepsy surgery and treatment-resistant seizures

Last updated: October 20, 2025 Treatment of seizures with brain surgery is an effective method for patients who have not responded to anticonvulsant drugs. In this method, by accurately identifying the focal point of the seizure in the brain, the doctor treats the traumatic area with surgery or nerve stimulation. The operation involves anesthesia, removal of part of the skull and mapping of the brain to preserve vital functions. After surgery, the patient is under special care and anticonvulsant drugs are continued to control the return of seizures. This process can lead to a sharp reduction or complete cessation of seizures and improve the patient's quality of life. stage Brief explanation for the patient Important point decision for surgery The doctor will determine if surgery is necessary by reviewing the results of the tests Decision making is completely specialized and individual Surgical procedure Anesthesia, removing part of the skull, brain mapping, treating traumatic tissue, closing the skull In some cases, part of the operation is performed with the patient awake to preserve vital functions Post-operative care ICU admission, pain control, monitoring of vital signs and brain function It is necessary to continue taking anticonvulsants Rehabilitation and return to normal life Gradual increase of activities, physiotherapy and counseling if needed Heavy activities should be done with the doctor's opinion Medications after surgery Most anticonvulsants are continued and the dose is gradually reduced according to the doctor's opinion Sudden discontinuation of the drug risks the return of seizures Surgery in children It is done more carefully so that the growth and function of the brain is not affected Special postoperative care is necessary for children

Seizure treatment steps with the help of brain function, diagnosis to treatment

The steps of treating seizures with the help of brain surgery begin with a careful examination and review of the medical history. At this stage, the neurologist examines the general condition of the patient and evaluates the medical history of the patient and his family to determine the factors affecting seizures. In addition, the presence of a person who witnessed the attack can provide the doctor with important information about the details of the seizures and is very useful in making a more accurate diagnosis.

The main goal of these investigations and subsequent tests is to identify the starting point of seizures in the brain; That is, the area where abnormal electrical activity causes seizures, and its identification is of great importance to choose the best treatment method, including brain surgery or brain tumor surgery if there is a lesion.

Important diagnostic tests:

  1. Encephalogram (EEG): Recording of brain electrical activity and identifying abnormal patterns
  2. MRI and CT scan: Examining the structure of the brain and diagnosing abnormalities, tumors or brain damage
  3. PET scan and blood test: help to diagnose the main cause of seizures
  4. Genetic tests (if needed): Investigation of hereditary factors related to seizures

After carefully examining and analyzing the results of all tests and diagnostic tests, the specialist doctor decides whether surgery is necessary and appropriate to control the seizures.

Types of surgical methods to treat seizures with brain surgery

To seizure treatment with brain surgery, there are various methods. These methods are specifically designed to control seizures, but if the seizure is caused by a lesion such as a brain tumor, you can also focus on brain tumor treatment at the same time. In the following, we will examine the three main methods and two more specialized approaches to seizure control.

Resective surgery (removal of epileptic focus)

In this method, the area of the brain that causes the seizure is carefully removed. For patients with a specific focus, this surgery has a high chance of reducing or stopping seizures.

Laser interstitial thermal therapy (LITT) in epilepsy

With the help of laser waves, the brain tissue causing seizures is precisely and minimally invasively heated and destroyed. This method has a shorter recovery period than open surgery.

Deep brain stimulation (DBS) for seizure control

Electrodes are implanted in specific areas of the brain to control nerve activity and reduce the number of seizures. This method is used for patients who are not suitable for resective surgery.

More specialized approaches such as callosotomy and hemispherectomy

In severe or complex cases where seizures are widespread, connectivity between the hemispheres is reduced or parts of the brain are separated to limit the spread of seizures.

What is the process of treating seizures with brain surgery?

The process of treating seizures with brain surgery begins with the preparation of the surgical area and anesthesia of the patient. The specialist doctor shaves a part of the patient's head and then puts the patient under complete anesthesia so that he does not feel any pain during the operation and is completely comfortable. During surgery, the intensive care team carefully monitors the patient's heart rate, blood pressure, and blood oxygen levels to ensure patient safety.

Key stages of brain surgery to treat seizures:

  1. Removing a small part of the skull and leaving it aside to access the brain.
  2. Using EEG to accurately identify the place where seizures start.
  3. In some cases, the patient wakes up for a few moments to answer the doctor's questions and brain mapping is done; This helps to maintain vital functions such as speech and movement.
  4. After the mapping, the patient is anesthetized again and the surgeon treats the brain tissue that is causing the seizure.
  5. restoring the skull bone and closing the scalp with a suitable bandage.

Significant advantages of surgery in seizure control

Surgery is one of the effective methods to treat seizures with brain surgery, especially in patients who have not responded to anticonvulsant drugs. The main benefits include:

  1. Reduction or cessation of seizures: Many patients experience significant reduction or complete cessation of seizures after resective surgery or laser interstitial thermal therapy.
  2. Improving the quality of life: Reducing seizures increases the patient's independence in daily activities, education and work.
  3. Decreasing the need for anticonvulsant drugs: With better control of seizures, the dose of drugs can be reduced and the side effects of drugs can be reduced.
  4. Psychological and social benefits: Better seizure control helps reduce anxiety and depression and improves the patient's social interactions.

According to Dr. Orrin Devinsky, an epileptologist at New York University: “For patients who do not respond to medications, surgery can completely change their lives and restore independence and quality of life.”

Probable side effects and risks of brain seizure surgery

Any brain surgery carries risks, and patients should be aware of them. The most important risks include the following:

  1. Bleeding and infection: Any surgical incision of the brain can cause bleeding or infection, although this risk is greatly reduced with advanced care.
  2. Temporary or permanent impairment in brain function: Depending on the location of the surgery, memory, speech or motor function may be temporarily affected.
  3. Seizures after surgery: In some patients, seizures may continue or even increase in the short term.
  4. Complications due to anesthesia: including nausea, vomiting or rare cardiovascular reactions.

According to Epilepsy Foundation:"Careful patient selection and surgery performed by an expert and experienced team is the most important factor in reducing complications and increasing treatment success."

What are the post-operative cares?

Care after brain surgery is very critical for seizure control and patient recovery. After surgery, the patient is usually admitted to the intensive care unit for a few days to be closely monitored. The medical team checks the patient's heart rate, blood pressure, breathing, level of consciousness and movement abilities and controls his pain with appropriate drugs. Adequate rest and accurate use of prescribed medications will help reduce post-operative symptoms such as headache, dizziness and fatigue.

  • Continuing anticonvulsant medication: Even if the seizures are reduced or stopped, suddenly stopping the medication is very dangerous and can cause the seizures to return.
  • Monitoring cognitive and behavioral status: Some patients may experience memory problems, concentration or mood changes, which are usually temporary, but psychological counseling is necessary if needed.
  • Gradual increase in daily activities: At first, heavy work and intense sports should be avoided, and with the passage of time and according to the doctor's opinion, activities should be gradually increased.
  • Rehabilitation and restoration of strength and flexibility: Physiotherapy and rehabilitation programs help the patient to return to normal life faster.
subject Short description Important point Duration of hospitalization A few days in the intensive care unit It depends on the complexity of the surgery Pain control Painkillers for patient comfort Controlled pain helps speed recovery Abnormal symptoms Headache, dizziness, fatigue may occur It's usually temporary, let me know if it's severe Cognitive symptoms Memory or concentration problems may occur They are mostly temporary, counseling is necessary if needed daily activity Start light activity, increase gradually Doing heavy work early is dangerous Rehabilitation Physiotherapy and rehabilitation program Adhering to the program will improve faster Anticonvulsant drugs Regular use of medicine as prescribed by the doctor Abrupt discontinuation carries the risk of seizure recurrence

Frequently asked questions about seizure treatment with brain surgery

Brain surgery to treat seizures in children: is it different?

Yes, pediatric brain surgery is significantly different because children's brains are still growing and developing. Doctors should be more careful in choosing surgical methods and areas to ensure that it has the least possible impact on the child's cognitive and neurological functions.

Also, after surgery, children may need extra care to ensure that no complications affect their normal development.

Will I need to take medication after brain surgery to improve seizures?

Yes, in many cases, patients still need to take anticonvulsants after brain surgery. These drugs help control seizures and reduce the risk of them recurring. Although surgery may greatly reduce or even stop seizures, doctors usually taper the medication gradually to prevent new seizures.

Does surgery affect daily activities?

Brain surgery can initially affect daily activities. Depending on the type of surgery and the area of the brain treated, patients may experience limitations in movement, memory, or concentration.

In the first days or weeks after surgery, it is necessary to rest and avoid heavy activities. But with the passage of time and following rehabilitation and physiotherapy programs, most patients return to their normal activities.

Comprehensive review of the operation process, costs and complications

Seizure treatment with brain surgery is an important and effective option for patients who continue to suffer from severe seizures despite the use of anticonvulsants. By focusing on identifying and treating the main source of this problem in the brain, this method can help significantly reduce or even completely stop seizures.

However, brain surgery is a big and complex decision that requires careful investigations, specialized tests and many consultations. After performing this operation, a period of special care and rehabilitation is necessary for the person to fully recover and return to normal life; Also, according to authoritative sources some patients may need to take anti-seizure medications to prevent recurrences.

If you have experience with seizure treatment, we would be happy to share your views in the comments section so that others can use your words and make better decisions.

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Dr. Yazdan Panahi

Student of Shahid Beheshti University of Tehran. The top rank of the specialized board of neurosurgery. 7-year history of performing complex operations on the base of the skull and brain and spinal cord tumors, 7-year history of complex operations on the spine

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