The UCSD Epilepsy Center is the combined effort of highly skilled neurologists, neurosurgeons, nurses, technicians and related staff, utilizing the most sophisticated diagnostics, medical therapies and surgical techniques available today.
Recent advancements in diagnostic technology have had a major impact on the success of seizure surgery.
The decision to operate is carefully weighed through a shared process of decision making by specialists at the UCSD Epilepsy Center, the referring physician, the patient and the patient’s family. Patients with well-localized seizure onsets are generally the best surgical candidates. The following sequence of evaluations is recommended:
- Comprehensive outpatient evaluation
- Magnetic resonance imaging (MRI)
- Inpatient EEG/video monitoring
- Neuropsychological evaluation
- Functional neuroimaging
- Language and memory lateralization (Wada) test
These tests provide complementary information to identify surgical candidates. The strategy of the experienced neurosurgeon is to maximize the removal of epileptogenic tissue and to minimize the risk of neurologic impairment. If the seizure focus is not revealed by non-invasive techniques, the patient may require a second telemetry admission for monitoring with implanted electrodes.
Who May Benefit From Surgery?
Patients are referred to the UCSD Epilipsy Center for sugical evaluation for a variety of reasons, including:
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Unsatisfactory seizure control
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Unacceptable side effects from antiepileptic drugs
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Psychosocial problems related to poor seizure control
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Structural focal brain lesion
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Self injury from uncontrolled drop attacks
The greatest surgical successes have been achieved in patients with partial seizures and a focus on one side of the brain. Some types of generalized seizure disorders are also responsive to surgical intervention.