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Focal Resection

Focal resection is a surgery to remove the portion of the brain responsible for seizures. While an entire lobe of the brain can be removed during surgery, focal resection typically involves removal of small parts of one lobe. Our experienced neurosurgeons perform focal resection at the Washington University and Barnes-Jewish Comprehensive Epilepsy Center, which is nationally recognized as an Epilepsy Center of Excellence.

While it is a big decision to remove a part of the brain, the risk of complications is very low. Our epileptologists and neurosurgeons have extensive expertise in evaluating patients and have performed epilepsy surgery in hundreds of cases. In fact, we treat a third of the epilepsy patients in the St. Louis region each year.

Why Focal Resection is Performed

When epilepsy patients do not respond to antiepileptic medication or other treatment options, focal resection may provide relief from seizures. Using advanced brain imaging and EEG testing, neurologists can determine where in the brain a patient’s seizures are originating. This process is called brain mapping. If all of the seizures are coming from a specific area in the brain, removal of that portion of the brain may put an end to the seizures.

The most common area of the brain for epilepsy surgery is the temporal lobe. During this procedure, known as temporal lobe epilepsy surgery, specific brain structures (the hippocampus and amygdala) or entire lobes of the brain are removed.

It is important to remember that the part of the brain causing seizures is already damaged and interfering with normal brain activity. Removal of this tissue often does not cause any significant loss of function and can sometimes result in improved function, especially if seizures become better controlled after surgery.

Am I a Candidate for Focal Resection?

Since removing part of the brain is irreversible, the utmost care is taken in confirming this is the best treatment option for you and avoiding permanent neurologic problems post surgery. Not all epilepsy patients are suitable for a focal resection. If your seizures originate from more than one area of the brain, or from an area that is too close to essential brain tissue, other treatment options will likely be considered.

The epileptologists and neurosurgeons at our Comprehensive Epilepsy Center work together to determine the best recommendation for your individual situation. Our advanced brain imaging equipment makes it possible to precisely locate seizure focal areas before and during surgery, resulting in the best outcomes for our patients.

To make an appointment with a Washington University epileptologist, neurologist or neurosurgeon at Barnes-Jewish Hospital, call 855.925.0631.

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