Epilepsy Surgery

preparing for surgery

Since November 2012 the NHS has altered the way epilepsy surgery for children is provided throughout the country. Four Children’s Epilepsy Surgery Services (CESSs) have been created to offer epilepsy surgery to many more children and young people with epilepsy. Sheffield Children’s Hospital works in partnership with our colleagues from Birmingham Children’s Hospital as a regional CESS Centre.

About a third of children presenting with epilepsy do not achieve good seizure control with antiepileptic medications and many of these children may be helped by epilepsy surgery. Epilepsy surgery can be highly successful in carefully evaluated infants, children and adolescents, bringing seizure freedom in about two thirds of cases.

Sheffield Children’s Hospital has a proven record for undertaking epilepsy surgery successfully over many years.

Epilepsy surgery team

The epilepsy team at Sheffield Children’s Hospital is multidisciplinary and includes neurologists, neurosurgeons, neuropsychiatrist, neuropsychologists, clinical neurophysiologists, nurse specialists, neuroradiologists, speech and language therapists, occupational therapists and physiotherapists.

Epilepsy surgery FAQs

Why would my child be considered for surgery?
What are the benefits of epilepsy surgery?
What are the risks of epilepsy surgery?
What happens when my child is admitted for epilepsy surgery?
How will my child feel when they leave hospital?
What happens after epilepsy surgery?
What if my child is not suitable for epilepsy surgery?

Tests and investigations

To decide if your child is suitable for epilepsy surgery they will need to undergo different tests and assessments. These investigations are designed to find out where in your child’s brain their seizures are starting and whether this area could be operated upon safely.

Assessments will also be done to assess your child’s memory, language, understanding (cognition). We will also be keen to assess the effect of seizures on their daily life, mood, behaviour and their social relationships.

These investigations will involve both outpatient and inpatient visits to the hospital and will be followed by a discussion of the results at our multidisciplinary team meetings.

Approximately 30-40% of children assessed for epilepsy surgery will be suitable to go forward for surgery. Once all the relevant information has been collated and discussed within the Children’s Epilepsy Surgery Service (CESS) we will be able to provide you with information about the options available to your child.

We try to ensure that all these tests and investigations are done as quickly as possible, but the timescale may vary depending on exactly what tests need to be done and where these will take place

Listed below are some of the tests and investigations that may be needed during your child’s assessment. These are provided at Sheffield Children’s NHS Foundation Trust unless specified otherwise.

EEG Electroencephalogram
Video Telemetry Recording
Magnetic Resonance Imaging (MRI Scan)
Functional MRI scan (fMRI Scan)
Positron Emission Tomography (PET Scan)
SPECT STUDIES Single-photon emission computed tomographye
Neuropsychometric Assessment
Neuropsychiatry Assessment
Therapy Assessment
Invasive EEG Monitoring

Types of surgery

  • Focal resection – a focal resection is recommended when the multi-disciplinary team is sure that the epilepsy is originating in one particular part of your child’s brain and that removing it will not cause your child any other problems. During this procedure a small part of the brain will be removed. There are two names for this type of surgery, temporal resection and extra-temporal resection:
    • temporal resection – this means your child requires surgery in one of their temporal lobes
    • extra-temporal resection – surgery to any other part of the brain (there are several different extra-temporal resections)
  • Hemispherotomy – this type of surgery disconnects one half of the brain from the other half to stop seizures from starting from a damaged part of your child’s brain. Children who already have a weakness on one side of their body may have this procedure. This is because they already have a pre-existing weakness on the side of the body which the planned surgery is likely to make weak.
  • Corpus callosotomy – this surgery separates the two hemispheres of the brain, and does not involve removing any brain tissue. This type of surgery is usually used for generalised seizures, and in particular drop attacks which are caused by the rapid spread of seizure activity from one side of the brain to the other. This surgery may also be recommended for children who have cyclonic seizures that affect the whole body.

Clinics

Clinics are held at the Ryegate Children’s Centre and Northern General Hospital.

To change or query appointments call 0114 305 3691.

Referrals

Referrals onto the Epilepsy Surgery Programme are co-ordinated by Barbara Warden, Epilepsy Nurse Specialist.

If you would like to discuss if epilepsy surgery may be suitable for your child please speak to your child’s consultant or contact the Neurology Team at the Ryegate Children’s Centre.

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