Craniotomy for Epilepsy / Temporal Lobectomy in India

Epilepsy surgery is considered for patients whose seizures continue despite adequate trials of anti-seizure medication, known as drug-resistant or refractory epilepsy. When tests show the seizures consistently originate from a specific, identifiable area of the brain, that area can potentially be removed surgically to stop or significantly reduce seizures. Temporal lobectomy, removal of a portion of the temporal lobe, is the most common and most successful form of epilepsy surgery, used when the seizure focus is located there.

How the seizure focus is found

Before surgery is recommended, a thorough pre-surgical evaluation confirms exactly where seizures start and rules out risk to important brain functions. This typically includes scalp EEG monitoring, detailed MRI imaging, and video-EEG recording to capture seizures directly. In some cases, more specialised functional imaging is used. This evaluation is essential, since the surgery's success depends on accurately localising the seizure focus and confirming it can be safely removed.

What surgery can and cannot do

During a craniotomy, part of the skull is temporarily opened to give the surgeon access, and the affected portion of brain tissue is carefully removed. Surgeons use imaging and, where needed, brain mapping techniques to protect areas controlling memory, language, and other critical functions while operating. Temporal lobectomy has the best outcomes of all epilepsy surgeries: more than 70% of patients remain seizure-free long-term, and most of the remainder see a significant reduction in seizure frequency. As with any brain surgery, there are risks, including possible effects on memory or mood, which are discussed individually before surgery.