Epilepsy surgery

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What you can expect

By Mayo Clinic staff

During the procedure
To avoid infection, your hair will need to be clipped short over the section of your skull that will be removed during the operation. Many times the neurosurgical team will be able to shave that area in such a way that other parts of your hair will cover up the bald patch after the surgery. Some people want their entire head shaved.

You will have an intravenous line in place, and your heart rate, blood pressure and oxygen levels will be monitored throughout the surgery. An EEG monitor also may be recording your brain waves during the operation to better localize the part of your brain where your seizures start.

Epilepsy surgery is usually performed under general anesthesia. That means you'll be asleep during the procedure, which involves making a small opening in your skull to access the brain. In rare circumstances, your surgeon may wake you up during part of the operation to help the team determine which parts of your brain control language and movement. After surgery the window of bone is replaced and fastened to the remaining skull for healing. Most epilepsy surgeries take at least four hours.

After the procedure
You'll be in a special recovery area to be monitored carefully as you awaken from the anesthesia. You may need to spend the first night after surgery in an intensive care unit. The total hospital stay for most epilepsy surgeries is usually about three or four days.

When you wake up, your head is going to be swollen and painful. Most people need narcotics for the pain for at least the first few days. An ice pack on your head also may help. Most postoperative swelling and pain resolves within several weeks.

You'll probably not be able to return to work or school for approximately three months. You should rest and relax the first few weeks after epilepsy surgery, and then gradually escalate your activity.

It's unlikely that you would need any rehabilitation as long as the surgery was completed without complications. Complications — such as stroke, paralysis or loss of speech — occur in about 1 percent of the most common variety of epilepsy surgery, where a section of the temporal lobe is removed.

MY00133

May 9, 2008

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