Epilepsy Surgery
At The Brain and Spine Centre, we specialize in the diagnosis and surgical treatment of neurological and spinal disorders. Dr. Muhammad Aqeel Natt, a leading neurosurgeon in Lahore, provides advanced, safe, and compassionate care for patients.
Epilepsy Surgery
Epilepsy surgery treats drug-resistant focal epilepsy by removing or disconnecting the seizure focus, offering seizure freedom or significant reduction in ~60-80% of suitable candidates. At The Brain and Spine Centre, Dr. Muhammad Aqeel Natt performs epilepsy surgery at Farooq Hospital, West Wood Branch, Lahore, for medically intractable cases after comprehensive presurgical evaluation including video-EEG, MRI, PET, and SEEG when needed.
Our goal is simple: localize and resect the epileptogenic zone safely, achieve seizure freedom, and improve quality of life while preserving neurological function.
What Is Epilepsy Surgery?
Epilepsy surgery targets the epileptogenic zone—the minimal brain area necessary and sufficient for seizure generation—using resective, disconnective, or neuromodulatory techniques for patients failing ≥2 appropriate antiepileptic drugs (AEDs). Curative procedures (resection) aim for seizure freedom; palliative procedures (callosotomy, neuromodulation) reduce severity/frequency.
Symptoms and Indications
Surgery is indicated for focal epilepsy with:
Drug-resistant seizures impairing quality of life after 2 failed AEDs.
Localizable epileptogenic zone on noninvasive evaluation.
Acceptable risk of deficit from resection.
Common surgically remediable syndromes:
Mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (best outcomes).
Lesional focal epilepsy (tumors, cavernomas, cortical dysplasia).
Extensive unilateral lesions (hemispherectomy).
Drop attacks (callosotomy).
Diagnosis and Evaluation
Multidisciplinary presurgical workup localizes seizure onset.
Video-EEG: captures seizures, defines semiology/onset zone.
High-resolution MRI: detects HS, lesions, malformations.
PET/SPECT/MEG: functional localization.
Invasive EEG (SEEG/grid): if noninvasive discordant.
Neuropsychology, Wada test, fMRI for function.
Surgical Options
Resective:
Anterior temporal lobectomy/amygdalohippocampectomy (ATLAH): gold standard for MTLE; 60-80% seizure-free.
Lesionectomy: for discrete lesions (DNET, cavernoma).
Focal corticectomy: neocortical epilepsy.
Disconnective:
Corpus callosotomy: anterior 2/3 for drop seizures (Lennox-Gastaut).
Hemispherectomy/functional disconnection: infantile hemiplegia syndromes.
Neuromodulation (palliative):
Vagus nerve stimulation (VNS), responsive neurostimulation (RNS), DBS.
The Procedure
At The Brain and Spine Centre:
Tailored craniotomy based on zone (temporal, frontal, etc.).
Intraoperative electrocorticography (ECoG), neuronavigation, neuromonitoring.
Microsurgical resection under microscope; tailored to margins confirmed by ECoG.
Laser interstitial thermal therapy (LITT) for deep lesions.
Recovery & Aftercare
Neuro-ICU 1-2 days; hospital 5-7 days.
AED taper if seizure-free after 2 years.
Neuropsych rehab, driving restrictions (6-12 months seizure-free).
Annual MRI/EEG follow-up.
Results You Can Expect
MTLE: 60-80% Engel I (seizure-free) at 1-2 years; sustained ~50-70% at 10 years.
Lesional: 70-90% seizure-free.
Callosotomy: 50-80% drop seizure reduction.
Morbidity: new deficit 2-5%; mortality <1%.
Why Choose The Brain and Spine Centre
Comprehensive epilepsy surgery program with presurgical evaluation, advanced imaging (3T MRI, PET), invasive monitoring, and functional neurosurgery. Expertise in MTLE, lesional epilepsy, and pediatric cases. Multidisciplinary team: epileptologists, neuropsychologists, neuroradiologists.
Cost of Epilepsy Surgery
Includes evaluation (EEG/MRI/PET ~high), surgery, ICU, rehab; varies by resection type. Estimates post-workup.
