What is functional neurosurgery?
It is a group of treatments that target specific neural circuits to improve symptoms of selected conditions. Examples include epilepsy surgery when a seizure focus can be identified and deep brain stimulation (DBS) for certain movement disorders. The goals, tests and risks differ by diagnosis, so the procedure is not chosen from the condition's name alone.
Assessment for epilepsy surgery
A person may be referred to a specialist epilepsy team when seizures continue despite appropriate medicines prescribed by their clinician. The International League Against Epilepsy generally defines drug-resistant epilepsy after failure of two tolerated, appropriately selected and used antiseizure medication schedules. This is a reason to seek specialist assessment, not automatic eligibility for an operation. Evaluation may include seizure history, EEG or video EEG, MRI and other tests as indicated.
Deep brain stimulation
DBS uses implanted electrodes connected to a device that delivers electrical pulses to selected brain areas. It may help control certain symptoms in carefully selected people with conditions such as Parkinson's disease, essential tremor or dystonia, and is used in some epilepsy cases. It is generally intended to reduce or manage symptoms, not cure the condition or stop every medicine. Programming and follow-up are important.
Decision-making and risks
The team weighs expected benefits, alternatives, test results and the effect of symptoms on daily life. Potential risks include bleeding, infection and anaesthetic complications; depending on the procedure and target, speech, balance, mood or cognitive changes can occur. Outcomes are not guaranteed. The clinic provides assessment and medical care; surgery, when indicated, takes place in hospital.
Frequently asked questions
Does failure of two medicines mean I need surgery?
No. It can prompt referral for specialist epilepsy assessment, but surgery requires a full evaluation and discussion of benefits, risks and alternatives.
Does DBS cure Parkinson's disease?
No. For selected patients, it may help control certain symptoms. It requires ongoing programming and clinical follow-up.
Will I stop epilepsy medicines after surgery?
Do not stop medication on your own. Your clinician will advise based on the procedure, seizures and follow-up.
What tests are used before epilepsy surgery?
Assessment may include EEG or video EEG, MRI and other tests selected by the epilepsy team for your situation.
Sources for further reading
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