Epilepsy & Seizure Surgery

When medication and lifestyle changes fail to significantly affect the seizures brought on by epilepsy, there are a variety of surgical interventions offered through the advanced skills of the Ayer Neuroscience Institute team.

Your specialist and others on your healthcare team will work with you to determine which, if any, of these procedures will help you.

Surgical patients are supported by our entire team, including mental health services, and any necessary physical, occupational and speech therapy after the procedure.

Neurosurgery


Types of Epilepsy & Seizure Surgery

Resective brain surgery

  • For this most common epilepsy and seizure surgery, an open procedure, surgeons remove a small portion of brain tissue in the area of the brain causing your seizures.
  • This type of surgery is often the best chance at a cure for epilepsy. We only recommend this surgery if the benefits far outweigh the risks of any long-term neurological damage.
  • Patients usually go home a few days after resective surgery.

Laser Ablation

  • In this procedure, our neurosurgeons use MRI to guide the use of laser interstitial thermal therapy. The laser is in a tiny probe that uses heat to target and destroy a very small area of brain that is causing the seizures.
  • Considered minimally-invasive because it does not require removing any parts of the skull (craniotomy), it has a relatively quick recovery time and patients usually go home the next day.  

Responsive neurostimulation (NeuroPace)

  • This is a treatment for reducing the frequency of seizures that can’t be controlled by medication or surgical resection.
  • A small, battery-powered device called a neurostimulator is implanted in the skull in the operating room. Wires, called leads, that are connected to the neurostimulator, are placed on and/or inside the brain. The neurostimulator monitors brain activity at all times and tries to stop seizures before they start.
  • Your epilepsy doctor can review data from your brain, as recorded by the stimulator, to see how well it is working, and adjust the programming settings at office appointments.
  • You can find more information at www.neuropace.com.

Deep brain stimulation (DBS)

  • This surgical procedure involves implanting electrodes in the brain to deliver electrical currents that block or change the abnormal activity that causes seizures.
  • Electrodes are placed in a part of the brain called the thalamus. They are connected by wires to a type of pacemaker device called an implantable pulse generator, which is placed under the skin below the collarbone.
  • Once activated, the pulse generator delivers electrical currents at regular intervals, modifying the abnormal brain activity and, therefore, reducing seizure frequency.
  • Because the device operates like a pacemaker for the heart, it is sometimes called a “pacemaker for the brain.”
  • Find more information at https://www.medtronic.com/us-en/patients/treatments-therapies/deep-brain-stimulation-epilepsy.html.

Vagus nerve stimulation

  • This is another type of “pacemaker for the brain” that is surgically implanted under the skin below the collarbone, with a wire connected to the vagus nerve in the neck. The device delivers an electrical current every few minutes to help adjust brain patterns and prevent seizures from starting.
  • Some patients use a hand-held magnet to activate the device if they feel a seizure starting. This can help make the seizure shorter or even stop it.
  • Find more information at https://www.livanova.com/epilepsy-vnstherapy/en-us.

Pre-Surgical Information for Medication-Refractory Epilepsy

Your epileptologist (seizure doctor) would like you to start the pre-surgical evaluation, which will determine if surgery could be a safe, effective option to stop or reduce your seizures.

The evaluation is tailored specifically to you and any recommendation is based on unique details of your seizures and their impact on your life. We would never schedule surgery without discussing it with you and your family, or without your approval.

With the pre-surgical evaluation, we will answer two important questions:

  1. Are there specific areas of your brain causing the seizures?
  2. Is there a surgical treatment that would be safe to do on that area without causing other problems?

To help answer these questions, your epileptologist will order many epilepsy presurgical tests. Tests can be done as close to your home as possible, but some require coming to Hartford. Most can be done in an outpatient setting, while others require a stay at Hartford Hospital.

The decision of whether surgery is safe for you is a very important one, guided by the Refractory Epilepsy Committee (REC), a multi-disciplinary panel of experts that includes epileptologists, neurosurgeons, neuropsychologists, neuroradiologists, health psychologists and others involved in your care.

When initial testing is complete, the REC meets and reviews your case. The group may ask for additional testing, followed by another review and, sometimes, even more tests. In the end, the REC will determine whether surgery would be a good treatment for you. Your epileptologist will explain the options available to you so you can choose the best one for you.

Think of this as “a marathon, not a sprint.” For most people, the testing and decision-making takes about six months, but it could take a year or longer.

Download the Pre-Surgical Information Sheet


Meet our Epilepsy Surgeons:

Mohamad Khaled

4.9

Neurosurgery

Medical Group Hartford HealthCare Medical Group at Hartford Hospital Department of Neurosurgery
Hartford, CT 06106
More Locations
Enfield, CT 06082
Brendan Killory

4.9

Neurosurgery

Medical Group Hartford HealthCare Medical Group at Hartford Hospital Department of Neurosurgery
Hartford, CT 06106
More Locations
Avon, CT 06001
Glastonbury, CT 06033
Patrick Senatus

4.7

Neurosurgery

The Ayer Neuroscience Institute
Hartford HealthCare HealthCenter - Tri City Plaza
Vernon, CT 06066

Hartford HealthCare Epilepsy Center