Epilepsy Surgery

Epilepsy surgery removes, disconnects or modulates the part of the brain where seizures start. It is considered for focal epilepsy that has not come under control after two properly chosen and dosed anti-seizure medicines, which describes roughly a third of people with epilepsy.

In well-selected temporal lobe epilepsy, around 6 to 7 in 10 people become free of disabling seizures. Results are lower when no lesion is visible on MRI or the focus lies outside the temporal lobe. Most people continue medicines for at least a year or two afterwards, and surgery is only as good as the evaluation that precedes it.

What Epilepsy Surgery involves

The evaluation is the larger part. It includes video-EEG telemetry over several days to record typical seizures, a 3 Tesla MRI with an epilepsy protocol, neuropsychological testing of memory and language, and often PET or functional MRI. If results disagree, electrodes are placed inside the skull (stereo-EEG) to pinpoint the onset. A multidisciplinary meeting then decides. For an anterior temporal lobectomy the neurosurgeon opens a window in the skull above the ear, removes the front of the temporal lobe with the hippocampus under the microscope, and closes with plates. Alternatives include lesion removal, laser ablation and stimulator implantation.

Who is a good candidate for Epilepsy Surgery?

Referral to a comprehensive epilepsy centre is appropriate once two medicines have failed; waiting many years is a common and avoidable mistake.

• Drug-resistant focal epilepsy with a clear lesion such as hippocampal sclerosis, cavernoma, low-grade tumour or focal cortical dysplasia
• Seizure recordings, MRI and neuropsychology that all point to the same area
• Children with catastrophic one-sided epilepsy syndromes, assessed in a paediatric programme
• People with drop attacks, for whom a palliative procedure may reduce injuries

It is usually not the right choice if:

• Generalised genetic epilepsies, which respond to medication and not to resection
• Epilepsy that has not yet had an adequate trial of two medicines
• Psychogenic non-epileptic attacks, which video-EEG distinguishes
• A seizure focus in essential language or movement cortex, where resection would cause unacceptable deficit; neuromodulation may be offered

الخيارات التقنية

• Anterior temporal lobectomy or selective amygdalohippocampectomy: The most frequent and best studied operation, for mesial temporal epilepsy.
• Lesionectomy: Removal of a defined lesion and surrounding abnormal cortex.
• Laser interstitial thermal therapy: A laser fibre destroys a small deep focus through a tiny hole. Shorter recovery, somewhat lower seizure freedom.
• Vagus nerve stimulation: A chest-wall pulse generator wired to the neck nerve. Reduces seizures in many but rarely stops them.
• Responsive or deep brain stimulation: For foci that cannot be removed or are in two places.
• Corpus callosotomy or hemispherotomy: Disconnection procedures, mainly in children with severe syndromes.

ماذا يحدث خلال علاجك

A resection takes 3 to 5 hours under general anaesthesia; selected cases near language areas are done awake for mapping. You spend the first night in intensive care or a high-dependency unit. Headache, jaw stiffness when chewing and swelling around the eye are common for several days.

الإعداد لرحلتك

Plan for 3 to 5 weeks including evaluation, often as two trips in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

التعافي والنتائج

Hospital stay is 4 to 7 days. Remain near the hospital for 2 to 3 weeks before a long flight. Tiredness, low mood and poor concentration can last 1 to 3 months. Return to work is typical at 6 to 12 weeks. Driving rules are set by your own country and usually require a long seizure-free period. Medicines are continued unchanged and any reduction is slow and supervised by your neurologist at home.

• Back to everyday activity: 6 to 12 weeks
• When results show: Outcome judged at 1 to 2 years
• How long they last: Often lasting; late relapse is possible

سياسة السلامة والمخاطر والتنقيح

Serious permanent complications occur in a small percentage of patients at experienced centres. Ask the team for their own figures.

• Loss of the upper outer quarter of vision on one side after temporal surgery, often unnoticed but occasionally affecting driving eligibility
• Decline in verbal memory, especially after dominant-side temporal resection
• Stroke, bleeding or infection including meningitis
• Word-finding difficulty, usually temporary
• Depression or anxiety in the months after surgery, even when seizures stop
• Seizures continuing or returning later
• Hardware infection or lead problems with stimulators

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Epilepsy Surgery in Türkiye

Clinic-Y does not publish a single price for Epilepsy Surgery, because the honest figure depends on your case. What moves it:

• Extent of pre-surgical evaluation, above all whether stereo-EEG is needed
• Type of operation or device; stimulators carry a high implant cost and later battery changes
• Intensive care and ward days
• Neuropsychology, PET and functional imaging
• Length of stay in the city for you and a companion

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

الأسئلة المتكررة