Epilepsy Center Surgical Expertise

Surgery for epilepsy is an individual decision, based on each patient’s unique needs and goals. When seizures are frequent or severe enough to significantly interfere with a person's ability to function at full capacity, surgery may be an option.

Surgery may also be considered appropriate after anti-seizure medications have not proved effective at controlling seizures.  Patients of any age, including infants, may be considered for surgery, depending on individual circumstances.

Our specialized team of neurologists, neurosurgeons, nurses and neuropsychologists carefully evaluates each patient being considered for surgery.

Surgical Treatments

A team of neurologists, neurosurgeons, nurse specialists, and neuropsychologists all participate in evaluating each patient being considered for epilepsy surgery.  Surgery for epilepsy is a complicated process which involves different surgical options.  The basic types of epilepsy surgery performed at Johns Hopkins are:

1. Focal resection – involves removing the portion of the brain where seizures of the brain originate.  The most common site for this is in the temporal lobe.  This procedure is effective only if seizures originate consistently from one location in the brain.  Depth, epidural and/or subdural electrodes may be implanted to further localize the site.
2. Vagus nerve stimulation - In this procedure a small pacemaker-like device is surgically implanted below the skin on the upper chest. The device delivers a small electrical current to the vagus nerve in the neck. An impulse continues up the nerve to the brain.  Our doctors recommend this treatment and find it an effective treatment for patients with epilepsy.
3. Hemispherectomy – a surgical procedure performed to remove the areas of the brain causing seizure activity.  During this procedure, almost half an entire hemisphere is removed.  Suitable for only a very few patients, hemispherectomy has proven to be a very successful type of seizure surgery.
4. Corpus Collosotomy – this surgery is performed in order to interrupt the pathway by which seizures spread, and does not remove the parts of the brain where seizures actually originate.  Thus the seizures are more likely to remain confined to a smaller part of the brain.  In preparation for surgery, it may be necessary to adjust some of your anti-convulsant medicines.  Patients who undergo this type of procedure generally are not candidates for other types of epilepsy surgery because their seizures usually originate in more than one area of the brain.
   

Experimental Treatments & Academic Research

A strength to providing clinical care within an academic setting like Johns Hopkins allows interaction with leading researchers engaging in work directly applicable to clinical treatments.  Currently, Johns Hopkins faculty are engaged in the activities of cortical mapping, language testing, and trials involving the application of new and exciting medications, diets and neurostimulation. Patients may be eligible to enroll in clinical studies that test new medications, new approaches to dietary therapy (modified Atkins diet for epilepsy), and new devices for the treatment of epilepsy.
Learn more about our Clinical Trials >>>

Over the years, the collective professional knowledge and resources associated with the Johns Hopkins Epilepsy Center have gradually shaped the landscape of epilepsy intervention for this and other treatment centers.