Epilepsy surgery

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How you prepare

By Mayo Clinic staff

If you're a candidate for epilepsy surgery, your pre-surgical evaluation may include:

  • Baseline electroencephalogram (EEG). In this test, electrodes are placed on the scalp to measure electrical activity produced by the brain.
  • Video EEG. A continuous EEG with video monitoring records your seizures as they occur. Because your seizure medications have to be reduced or temporarily stopped so that seizures will occur, you'll have to be admitted to the hospital for this test. Correlating the changes in your EEG with your body's movements during a seizure helps "pinpoint" the area of your brain in which your seizures are starting.
  • MRI or CT of the head. MRI and CT scans can identify structural problems — such as lesions or scar tissue in the brain — that could be causing seizures.
  • Positron emission tomography (PET) and functional MRI. PET and functional MRI scans can monitor the brain's activity and detect abnormalities.
  • Single-photon emission computerized tomography (SPECT). The scan image varies in color depending on the amount of blood flow in different areas of the brain. Typically, blood flow is higher in the part of the brain where seizures originate. In some cases, doctors combine several types of imaging techniques to help locate the troublesome area of the brain.
References
  1. Brunicardi FC, ed., et al. Schwartz's Principles of Surgery. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=50. Accessed Sept. 19, 2012.
  2. Ropper AH, et al. Adams & Victor's Principles of Neurology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=54. Accessed Sept. 19, 2012.
  3. Rowland LP. Merritt's Neurology. 12th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2010. http://gateway.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&PAGE=main&D=baov&PCOSTART=merritt. Accessed Sept. 19, 2012.
  4. Seizures and epilepsy: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm. Accessed Sept. 19, 2012.
  5. Surgery. Epilepsy Foundation. http://www.epilepsyfoundation.org/aboutepilepsy/treatment/surgery/index.cfm. Accessed Sept. 19, 2012.
  6. Engle J, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy a randomized trial. Journal of the American Medical Association. 2012;307:922.
  7. Wirrell EC (expert opinion). Mayo Clinic, Rochester, Minn. Sept 27, 2012.
MY00133 Oct. 19, 2012

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