Epilepsy - Lifestyle Changes

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In general, surgical effects on mental functioning and behavior depend on the extent and location of the surgical area.

Lesionectomy

Lesionectomy is a procedure that is performed to remove a lesion in the brain. Brain lesions are damaged or abnormal tissues that may be caused by:

• Cavernous angiomas (abnormal clusters of blood vessels)
• Low-grade brain tumors
• Cortical dysplasias (these are a type of birth defect in which the normal migration of nerve cells is altered)

Lesionectomy may be appropriate for patients whose epilepsy has been identified as associated with a defined leision and whose seizures are not well controlled by medication.

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Vagus Nerve Stimulation (VNS)

Electrical stimulation of areas in the brain that affect epilepsy can help many patients with refractory epilepsy. Vagus nerve stimulation (VNS), an electrical stimulation of the vagus nerve, is now an accepted therapy for severe epilepsy that does not respond to AEDs. The two vagus nerves are the longest nerves in the body. They run along each side of the neck, then down the esophagus to the gastrointestinal tract. They affect swallowing, speech, and many other functions. They also appear to connect to parts of the brain that are involved with seizures. The procedure is as follows:

Click the icon to see a depiction of epilepsy treatment.

• A battery-powered device similar to a pacemaker is implanted under the skin in the upper left of the chest.
• A lead is then attached to the left vagus nerve in the lower part of the neck.
• The neurologist programs the device to deliver mild electrical stimulation to the vagus nerve. (Patients may also pass a magnet over the device to give it an extra dose if they sense a seizure coming on.)
• The batteries wear out after 3 - 5 years and need to be removed and replaced by a simple surgical procedure.

Candidates. The American Academy of Neurology recommends VNS for:

• Patients who are over 12 years old, and
• Have partial seizures that do not respond to medication, and
• Are not appropriate candidates for surgery