The Washington University Pediatric Epilepsy Center at St. Louis Children’s Hospital is home to nationally recognized pediatric epilepsy experts. Our team offers the latest surgical treatments for children with complex types of epilepsy.
While most epilepsy surgeries in adults involve the temporal lobe, in children, seizures can often start in other regions of the brain. While more challenging to localize and treat, extratemporal epilepsy surgery has shown promising benefits for some children when medication doesn’t offer meaningful seizure improvement. This surgery has led to fewer or less severe seizures for many children, while others now enjoy a seizure-free life.
What Is Extratemporal Resective Surgery?
Resective epilepsy surgery involves removing a piece of brain tissue that isn’t working properly. In extratemporal resective surgery, neurosurgeons remove (resect) the section of the brain where the seizures start.
“Extratemporal” means the affected brain tissue lies outside of the temporal lobe (a section of the brain located behind the ears).
In certain patients, surgery can significantly lessen the number or severity of seizures, leading to meaningful improvements in quality of life. Some children experience no seizures at all after surgery.
When Is Extratemporal Epilepsy Surgery Offered?
Your doctor may suggest surgery after two or more medications have failed to improve or control your child’s seizures. We consider extratemporal epilepsy surgery when diagnostic tests show that a child’s seizures start in one specific region of the brain. If doctors are confident that removing the area of seizure onset (where seizures start) won’t hinder key brain functions, they may offer this surgery as a treatment.
Minimally invasive surgical techniques and image guidance technology have improved epilepsy care in recent years. Due to these care advances, our doctors are able to offer this surgery to more children than ever before.
Extratemporal Epilepsy Surgery: What to Expect
Before extratemporal epilepsy surgery, your child will undergo a sophisticated diagnostic procedure. It allows our doctors to map out the exact area of the brain that is causing concern. This process increases precision and helps surgeons remove only the tissue that causes seizures, without harming nearby healthy tissue.
During extratemporal resection surgery, a surgeon will:
- Make incisions into the skull, to access brain tissue
- Use MRI imaging technology to precisely remove only the tissue that causes seizures
- Leave nearby brain tissues intact, to retain normal function in healthy tissues
- Close up the skull using small titanium brackets, and the scalp using dissolving sutures
A Family-Centered Approach to Epilepsy Brain Surgery
We understand the weight of considering brain surgery for your child. Our team is committed to guiding families through this process, with expertise and compassion. At our Pediatric Epilepsy Advanced Technologies Clinic, we make it easier for children with treatment-resistant epilepsy to benefit from our world-class pediatric expertise.
At this clinic, doctors conduct a thorough evaluation of your child’s health and take the time to address your questions or concerns. We discuss all of your child’s treatment options. A nurse coordinator helps schedule any additional diagnostic tests your child may need and walks you through next steps.
Learn more about the careful consideration that goes into evaluating a child for surgery in our helpful guide to the patient journey.