Surgery is recommended for an epilepsy patient when medications do not manage the seizures. The surgery goal is either to end the seizures (curative) or decrease their incidence and severity (palliative).
Curative procedures are when the seizures are connected to a definite area of the brain. It includes eliminating the definite area of the brain tissue producing brain dysfunction. Depending on the part of the brain removed the surgery is categorized as temporal lobectomy, cortical excision and hemispherectomy.
Palliative procedures are performed when either a definite brain area cannot be related with the seizure or the specific area overlies a crucial part of the brain. It comprises inhibiting the spread of the seizures by detaching the nerve fibers in the brain by constructing sections or incisions in the brain. Another palliative procedure is vagus nerve stimulation. This encompasses implantation of a pacemaker like electrical pulse generator on the left side of the chest. This is attached through a wire to two electrodes which are looped to the vagus nerve in the neck. The patient can switch on the system when a seizure is starting. The pulse generator delivers electrical impulses to the brain through the vagus nerve when turned on and helps prevent seizures.