Epilepsy Surgery

While seizures for many patients can be controlled effectively with medication, about 25 to 30 percent of children continue to have difficult-to-control epilepsy. Some of these patients may benefit from surgical intervention. Curative surgery for seizures includes operating on the portion of the brain responsible for seizure onset. Other special surgical procedures, such as a hemispherectomy, corpus callosotomy or implantation of vagus nerve stimulators, are used to improve seizure control.

As a level-four Epilepsy Center, we are able to assess children with medically refractory seizures where the cause of the seizure is identified by MRI abnormality, as well as cases where the MRI is normal. We also conduct functional cortical mapping by stimulation of subdural electrodes either extra-operatively or intraoperatively.

We have the most up-to-date EEG monitoring equipment to help us determine the part of the brain that is responsible for the seizures. The video telemetry unit incorporates continuous EEG monitoring with simultaneous digital video recordings to time-lock clinical events to the EEG. Advanced imaging techniques such as SPECT studies, PET scans, and functional MR imaging are also used to help identify where the seizure starts in the brain. For some children with intractable seizures the exact location of seizure onset is difficult to locate, therefore EEG recordings directly from the surface of the brain are necessary to help determine the area of surgical resection.

Diagnostic Studies for Surgery Evaluation

• 24-hour, long-term video EEG monitoring in a unit specifically designed for children

• Diffusion tensor imaging

• Functional MRI

• High field, detailed MRI

• Neuropsychological evaluation

• PET (Positron Emission Testing)

• Routine digital/video EEG

• Intra-operative and extra-operative studies to localize language and motor functions

• SPECT (Single Photon Emission Computerized Tomography)

Multidisciplinary Care

Surgical Epilepsy services at Nationwide Children’s Hospital involves an array of multidisciplinary specialists to care for the clinical, surgical and psychosocial needs of children with difficult to control epilepsy. From leading pediatric neurologists who specialize in epilepsy evaluation and treatment, and a variety of other professionals, our program provides comprehensive care and employs advanced diagnostic and management techniques to provide the best possible outcomes for successfully curing epilepsy. Services include the following disciplines:

• Anesthesiologists

• Child Life Specialists

• Neurodiagnostic Technicians

• Neurologists, Epileptologists

• Neuropsychologists

• Neuroradiologists

• Neurosurgeons

• Nuclear Medicine Specialists

• Nurses

• Pathologists

• Pediatric Nurse Practitioners