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Risks & Benefits of Epilepsy Surgery

Learn about the risks and benefits of epilepsy surgery from Steve Wolf, MD, and Patty McGoldrick, NP, in this Howcast video.


Steve Wolf: The benefits of epilepsy surgery are huge and the risks are small. You know, it's important to know is if we don't control your seizures it's going to affect your job, your life, and there's always a risk of death if your seizures are not controlled. So if we can control someone's seizures with surgery, we can change everything about that patient.

Patty McGoldrick: And we can keep them alive, there is a big risk of something called SUDA, which is Sudden Unexpected Death in Epilepsy that's much more common in people who have uncontrolled seizures. So if we can do surgery, and have the seizures controlled, we're much more likely to have a good outcome. We don't do epilepsy surgery necessarily to cure the seizures and get rid of all of them, but we do it to reduce the seizure loads so there are fewer seizures.

Steve: But everybody worries about the risks. They think that surgery is going to change the personality of the person, create paralysis, cause severe brain damage, but if you don't control the seizures, you're going to have more problems. But now with the new technology, double checking thinking, doing functional MRIs, brain mapping, we're really able to cut the risk down of those things that everybody worries about.

Patty: The biggest risks is with any surgery are things like infection and bleeding and really there's a very, very low percentage of risk of either of those in epileptic surgery. And what we do is, as Steve was talking about with the different testing that we do, we do all these mechanisms so that we can avoid the areas of the brain that are controlling important processes. So we can go in and map the brain during the surgery and figure out where movement in the arms is, where movement in the legs, where speech is, where language is, where memory is and avoid those areas and just resect the very small area of the brain that's causing the seizures.

Steve: So if you're a candidate for epilepsy surgery, the benefits could be huge, change your life, stop the seizures from happening, allow you to work, possibly even come off all your seizure medication and not have the side effects of the seizure medication. The risks are small like any surgery. The risk of infection. The risk of bleeding. But even those, with modern technology, are small. The risks that everybody worries about changing personalities is really not necessary. The risk of affecting language, or speech, or motor movements are protected by doing functional MRIs and brain mapping. So again, going to an epilepsy center that has all these double checks and balances as part of it, going to places where they do this kind of surgery . . .

Patty: All the time.

Steve: . . . all the time, it's like landing a plane, is an important part of making sure you're the right candidate for surgery and decreasing the risks, but maximizing the benefits, so you will be a successful epilepsy surgery patient.

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