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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. Shaving is not done if the surgery is for a child.
You will have an intravenous access 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 during general anesthesia. That means you'll be unconscious during the procedure, which involves making a small opening in your skull to access the brain. In rare circumstances, your surgeon may awaken you 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 after 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 awaken, your head will 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 resolve within several weeks.
You'll probably not be able to return to work or school for approximately one to 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 intensive rehabilitation as long as the surgery was completed without complications such as stroke, paralysis or loss of speech.
- 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.
- 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.
- 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.
- 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.
- Surgery. Epilepsy Foundation. http://www.epilepsyfoundation.org/aboutepilepsy/treatment/surgery/index.cfm. Accessed Sept. 19, 2012.
- 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.
- Wirrell EC (expert opinion). Mayo Clinic, Rochester, Minn. Sept 27, 2012.
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