Symptom management through medication is the mainstay of treatment. Medications such as Dilantin, Tegretol, Phenobarbitol, Valproic Acid and Neurontin are known to be effective.
Surgery can be performed to remove a seizure-causing leision. A temporal lobectomy is done to remove the structures causing the seizures.
Vagus Nerve Stimulator
Vagus Nerve Stimulation (VNS) therapy is effective in reducing the frequency of seizures in adults and adolescents who have had little success with antiepileptic medications. Vagus means wanderer in Latin. The vagus nerve is one of the primary communication lines from the major organs of the body to the brain. VNS therapy uses an implantable device, much like a pacemaker, to send signals from the vagus nerve in the neck to the brain. The VNS pulse generator and lead are implanted in the chest and neck in a procedure that involves 45 minutes to 2 hours of surgery time and two incisions; a small incision on the side of the neck for the lead and a small chest incision for the generator.
The VNS Therapy System delivers VNS therapy in two ways. First, your doctor will program a 24-hour-a-day, 7-day-a-week "dose" of periodic stimulation. The patient, a family member or a caregiver also can deliver VNS therapy when they sense a seizure coming on. Passing a special VNS magnet over the area in the chest where the generator is implanted activates stimulation.
This method of removing brain tissue is restricted to patients with severe epilepsy and abnormal discharges that often extend from one side of the brain to the other. Hemispherectomies are most often performed on infants or young children who have had an extensive brain disease or have suffered from seizures since birth or from a very young age.
Multiple subpial transections
This procedure is used to control the spread of seizures that originate in or affect the "eloquent" cortex, the area of the brain responsible for complex thought and reasoning.