Epilepsy Surgery
Epilepsy surgery treats seizures that are not controlled by medication by removing or disconnecting the small area of brain where the seizures begin, or by implanting a device that interrupts them. After a detailed evaluation to locate the seizure focus precisely and confirm surgery is safe, it can free suitable patients from seizures or greatly reduce them.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
Epilepsy surgery is considered when seizures continue despite trials of appropriate medication (drug-resistant epilepsy). The goal is either to remove the small region where seizures start (resective surgery), to disconnect pathways that let seizures spread, or to implant a neurostimulation device that detects and interrupts seizure activity. The right option depends on where the seizures begin and whether that area can be treated safely.
A thorough evaluation comes first and is the most important part. It typically includes video-EEG monitoring to record seizures, high-resolution MRI, and functional tests to map areas controlling speech, movement and memory. For some patients, electrodes placed on or in the brain pinpoint the seizure focus before any treatment is planned. This careful work-up determines whether surgery is both possible and safe.
Care is planned by an epilepsy team of neurologists and neurosurgeons working together. International patients receive a coordinator, a clear plan and a transparent cost estimate before travel, and our specialists can review EEG and MRI records remotely first to advise whether a surgical evaluation is worthwhile.
Who is a candidate?
- People whose seizures are not controlled despite trials of appropriate anti-seizure medication
- Patients whose seizures appear to start in one identifiable area of the brain
- Those whose seizure focus can be treated without harming vital functions, as shown by evaluation
- People troubled by frequent seizures that limit independence, work or driving
- Patients seeking expert assessment of whether they are candidates for surgery
What happens
- 1
Comprehensive evaluation
Video-EEG monitoring, high-resolution MRI and functional testing locate where seizures begin and map nearby areas controlling speech, movement and memory.
- 2
Detailed mapping if needed
For some patients, electrodes placed on or in the brain record seizures directly to pinpoint the focus precisely and confirm that surgery would be safe.
- 3
Planning the approach
The epilepsy team decides with you whether to remove the seizure focus, disconnect spreading pathways, or implant a neurostimulation device, based on the evaluation.
- 4
The procedure
Under general anesthesia — with awake mapping in selected cases near speech areas — the surgeon removes or disconnects the seizure focus, or implants the stimulation device, using navigation and monitoring.
- 5
Recovery and medication review
You recover over several weeks, and your neurologist adjusts anti-seizure medication gradually based on your response. International patients receive a clear follow-up plan, with remote support after returning home.
Benefits
- Can free well-selected patients from seizures or greatly reduce their frequency
- May allow a reduction in anti-seizure medication over time
- Restores independence affected by frequent seizures, such as driving or working
- Detailed evaluation ensures surgery is recommended only when it is both possible and safe
- Neurostimulation offers an option when removing the focus would not be safe
Risks & considerations
- Surgical risks including bleeding, infection and reaction to anesthesia
- Possible effects on memory, language or movement depending on the area treated, which mapping aims to avoid
- Seizures may not stop completely in every patient, even with a good evaluation
- Medication is usually still needed for a period after surgery
- A thorough, sometimes lengthy evaluation is required before any surgery
Conditions this treats
Where it is performed
This procedure is delivered by our Neurological Sciences Center.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Epilepsy Surgery — frequently asked questions
People whose seizures are not controlled by medication and whose seizures start in one identifiable area that can be treated safely. A detailed evaluation determines whether surgery is both possible and safe for you.
It typically includes video-EEG monitoring to record seizures, high-resolution MRI, and functional tests to map speech, movement and memory. Some patients also need electrodes placed to pinpoint the seizure focus before any surgery is planned.
Many well-selected patients become seizure-free or have far fewer seizures, but no operation can guarantee complete freedom from seizures. Your epilepsy team gives you a realistic, individual assessment based on your evaluation.
Yes. Share your EEG, MRI and seizure history and our specialists advise whether a surgical evaluation is worthwhile, before you commit to travel.
Plan for the monitoring evaluation plus several nights after surgery and recovery before flying — your coordinator confirms the timeline. We provide a transparent, itemized estimate after reviewing your case rather than a fixed online price, because the evaluation and procedure are individual.
Related treatments
Considering epilepsy surgery?
Share your reports for a medical second opinion and a transparent, itemized cost estimate — usually within 48 hours.