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MINCEP® Surgical Program
Surgery For Epilepsy Has Become Increasingly Successful
Surgery is now the treatment of choice for many patients. Many hospitals throughout the United States are now trying to perform epilepsy surgery, in part for bragging rights and in part because they think it will make money. The best surgeon, or even the best team of surgeon and epileptologist, if isolated from a broader team providing comprehensive care, is not able to do the entire job. MINCEP merges its surgical program into its entire epilepsy treatment program. We strive to do the right surgery on the right patient as soon as it is indicated. We try not to do surgery if it is not going to help. Although we are one of the leading epilepsy surgery programs in the world, we do not measure our success by the number of "procedures" we do each year.
We have a long history of effective surgical treatment. The MINCEP team has performed hundreds of anterior temporal lobectomies, many temporal and extra-temporal resections requiring implanted electrodes, and many sections of the corpus callosum. Hemispherectomies are also performed by MINCEP. We are also fully experienced in implanting the Vagus Nerve Stimulator. Our surgery success rate is outstanding. We average more than one surgical procedure a week.
Many patients who come to MINCEP for an evaluation will opt to have the surgery performed at MINCEP when the evaluation is complete. We will work with your local doctor for ongoing treatment.
MINCEP is actively involved in developing new surgical techniques. We are a part of two multi-institutional research projects funded by the National Institutes of Health. One is exploring early surgical intervention and the other the outcome of anterior temporal lobectomy.
The vagus nerve stimulator (VNS) may be useful for people with intractable epilepsy who are not good candidates for resective epilepsy surgery.
The VNS is a device similar to a cardiac pacemaker. Wires extend from the stimulator (which is usually implanted in the chest) and wrap around the left vagus nerve in the neck. The stimulator intermittently delivers a mild electrical current which may interrupt seizures. Patients may experience a reduction in the severity and frequency of their seizures, however, vagal nerve stimulation never results in a cure, and almost never produces complete seizure control. Approximately half the patients who have the VNS experience at least a 50 percent reduction in seizure frequency that persists for one year or longer.
People who experience a warning before their seizures can place a magnetic device over the stimulator to activate it. Activation of the stimulator at that time may help stop or shorten the length of the seizure. The VNS can be adjusted externally by a physician.
Except for a particular subset of patients (those diagnosed with intractable partial epilepsy, generalized seizure syndromes and Lennox Gastaut Syndrome), the VNS rarely reduces seizures. It is important that all treatment options be considered before VNS implantation. Resective epilepsy surgery or treatment with the newer antiepileptic medications may be more appropriate and cost-effective than the VNS in many situations. To be sure the diagnosis warrants treatment with the VNS, consult a comprehensive epilepsy center for a complete evaluation first.