By Dr. Shyam D, Board-Certified Neurosurgeon in India
Published: March 24, 2025
As a board-certified neurosurgeon with over a decade of experience in India, I’ve witnessed the transformative power of epilepsy surgery in freeing patients from the grip of uncontrollable seizures. Epilepsy can be a relentless condition, but when medications fail, surgery offers hope—a chance to reclaim a life unshadowed by sudden, unpredictable episodes. In this pillar page, I’ll explain what epilepsy surgery entails, who it’s for, how it’s performed, and how my team and I help patients thrive. Whether you’re a patient, parent, or caregiver, this guide is designed to inform, reassure, and empower you.
What Is Epilepsy Surgery?
Epilepsy surgery is a specialized procedure to reduce or eliminate seizures in patients with epilepsy—a neurological disorder marked by recurrent, unprovoked seizures caused by abnormal brain electrical activity. While many manage epilepsy with drugs, about 30% of patients have drug-resistant epilepsy, where seizures persist despite treatment. That’s where I step in. With over ten years of performing these intricate surgeries, I’ve seen how removing or altering the seizure-causing brain area can change lives.
Types of Epilepsy Surgery
Epilepsy surgery isn’t one-size-fits-all—it’s tailored to the seizure’s origin and the patient’s needs. Here are the main approaches I use:
- Resective Surgery
- Temporal Lobectomy: Removing part of the temporal lobe, common for focal seizures.
- Lesionectomy: Excising a specific lesion (e.g., tumor, scar) triggering seizures.
- Extratemporal Resection: Targeting seizure zones outside the temporal lobe, like the frontal or parietal regions.
- Disconnective Surgery
- Corpus Callosotomy: Cutting connections between brain hemispheres to stop seizures from spreading, often for severe generalized seizures.
- Multiple Subpial Transection (MST): Making small cuts in the cortex to disrupt seizure spread without removing tissue, used when the area controls vital functions.
- Neuromodulation
- Vagus Nerve Stimulation (VNS): Implanting a device to stimulate the vagus nerve, reducing seizure frequency.
- Responsive Neurostimulation (RNS): A device detects and stops seizures with electrical pulses.
- Deep Brain Stimulation (DBS): Electrodes in deep brain structures modulate activity.
Each type reflects my expertise in balancing seizure control with preserving brain function—a precision honed over a decade.
Symptoms and Signs Leading to Surgery
Epilepsy surgery isn’t for everyone—it’s for those with drug-resistant seizures impacting life. Here’s what I look for:
- Frequent Seizures: Multiple episodes monthly despite trying several medications.
- Focal Seizures: Originating in one brain area, often with auras (e.g., odd smells, déjà vu) or localized movements.
- Severe Impact: Disrupted school, work, or safety (e.g., falls, driving risks).
- Generalized Seizures: Rare for surgery, but disconnective options help in extreme cases.
I recall a teen whose daily seizures kept her from school. Tests showed a temporal lobe focus—surgery stopped them, and she’s now thriving in college. Identifying candidates is step one.
How Is Epilepsy Surgery Evaluated and Diagnosed?
Deciding on surgery requires pinpointing the seizure source. My diagnostic process is rigorous:
- Medical History: I ask about seizure frequency, triggers, and drug trials—two failed medications often signal resistance.
- Electroencephalogram (EEG): Scalp or intracranial electrodes map brain activity, locating the “epileptogenic zone.”
- Imaging:
- MRI: Spots structural causes like scars or tumors.
- PET/SPECT: Highlights metabolic or blood flow changes in seizure areas.
- Neuropsychological Testing: Assesses memory, language, and risks of surgery near critical areas.
- Wada Test: Determines language and memory dominance to plan safely.
With over ten years analyzing these tools, I can confirm if surgery is viable—ensuring we target the right spot with minimal collateral impact.
Epilepsy Surgery Treatment Options
Once we identify the seizure focus, I tailor the approach:
- Resective Surgery
- I remove the epileptogenic tissue—often a small area—using microsurgery and intraoperative monitoring to protect speech or movement zones. Success rates soar (60-90% seizure-free for temporal cases).
- Disconnective Surgery
- For widespread seizures, I sever pathways—like the corpus callosum—reducing severity without major resection. Ideal for kids with drop attacks.
- Neuromodulation
- VNS, RNS, or DBS offers alternatives when resection isn’t safe. I’ve implanted these in patients with deep or multiple foci, cutting seizure rates by 50% or more.
- Laser Ablation
- A minimally invasive option, using heat to destroy seizure tissue through a tiny hole—faster recovery, less risk.
How We Help Patients: A Path to Freedom
Epilepsy surgery is about more than stopping seizures—it’s about restoring normalcy. Here’s how my team and I support patients:
- Personalized Plans: A young man with frontal lobe seizures got a resection, ending years of disruption. An older woman with multifocal epilepsy chose VNS, regaining independence. Every case gets my full attention.
- Patient & Family Education: I explain risks (e.g., 1-5% chance of deficits) and benefits (e.g., seizure freedom) clearly, easing fears. We offer counseling for emotional support.
- Precision Surgery: Using neuronavigation and awake mapping, I protect vital functions—patients speak or move during surgery to guide me.
- Rehabilitation: Post-op, I connect patients with therapists—speech for language recovery, physical for strength—to maximize gains.
- Follow-Up: Regular EEGs and visits track progress. I’ve watched patients go years seizure-free, celebrating their milestones.
One patient—a 30-year-old chef—had seizures ruining his career. A temporal lobectomy stopped them, and he’s back in the kitchen. That’s the impact we chase.
Causes and Risk Factors
Epilepsy needing surgery often ties to:
- Structural Issues: Brain scars (e.g., from trauma), tumors, strokes, or malformations.
- Genetics: Rare syndromes like tuberous sclerosis.
- Infections: Meningitis or encephalitis leaving scars.
Prevention isn’t always possible, but helmets, infection control, and early seizure management reduce risks. Surgery steps in when drugs can’t.
Why Choose Dr. Shyam D for Epilepsy Surgery?
With over a decade of experience, I’ve mastered epilepsy surgery—resecting precise zones, implanting devices, all with tools like intraoperative EEG and robotics for accuracy. My board certification, earned through India’s top system, and my engagement with global epilepsy advancements (e.g., conferences on RNS) affirm my authority. My compassion—treating each patient like family—builds trust. Whether it’s a child with daily fits or an adult seeking relief, I’m here to deliver results.
Life After Epilepsy Surgery
Outcomes vary: resective surgery often brings seizure freedom (60-80% for focal cases), while neuromodulation reduces frequency. Some face temporary deficits—memory or speech—but rehab helps. I’ve seen patients return to school, jobs, and driving—lives unshackled. My role is to make that possible with expertise and care.
Final Thoughts
Epilepsy surgery is a lifeline for those trapped by seizures. With over ten years of precision and patient-first care, I’m committed to helping you or your loved one break free. If seizures persist despite medication, don’t wait—reach out. Together, we’ll map the path to a seizure-free future.
Dr. Shyam D is a distinguished board-certified neurosurgeon in India, with over a decade of expertise in intricate brain and spine surgeries. Renowned for his precision and compassionate care, he transforms lives through epilepsy surgery.