Epilepsy Center

Appointments

Clinical Services

Clinical Trials & Research

Epilepsy Monitoring Unit

Epilepsy Surgery

Deciding To Get Surgery

Frequently Asked Questions

Procedures

Surgical Outcomes

Non-Epileptic Spells

Our Team

Resources & Support

The decision to proceed from medical therapy to epilepsy surgery is not taken lightly.

It is carefully weighed through a shared process of decision-making by professionals at the UCSD Epilepsy Center, the referring physician, the patient and the family.

Video-EEG Monitoring is a critial step in determining if a patient may be a good candidate. Elective admission to the Epilepsy Monitoring Unit:

• Excludes the possibility of non-epileptic attacks
• Identifies the type and location of the seizures
• Verifies that medical therapy is ineffective

Patients with seizures that begin from a single "hot spot" or seizure focus may benefit from a surgical treatment to remove the "hot spot," if this can be done without inquiry to other parts of the brain. Doctors at the UCSD Epilepsy Center spend a great deal of time evaluating patients to determine if epilepsy surgery may help them to control seizures which are not controlled by medicine alone.

Presurgical Evaluation

• As part of the presurgical evaluation, high resolution imaging of the brain is performed. This includes MRI with special techniques to increase the chance of detecting abnormalities.
  
  
• In some cases, magnetoencephalography (MEG) can help to combine information from brain waves and brain pictures to help doctors to locate the areas of abnormalities (the seizure focus).
  
  
• During the evaluation, the patient is given a series of psychological tests to localize their language function and assess memory capabilities.
  
  
• A WADA test is done to assess the functional lateralization of language and memory, and requires the participation of neuroradiologists. The technique is similar to that of carotid angiography and requires selective catherization of each carotid artery via a femoral approach. A short-acting barbiturate is injected on each side, and the function of the other hemisphere is assessed with a specific battery of language and memory tests. The purpose of this test is to insure that the operation will not result in language or memory deficits.