Some typical forms of epilepsy caused by lesions can be safely removed.
Twenty five percent of patients with epilepsy will have lesions identified by MRI as the cause of recurrent seizures. Abnormalities such as low grade astrocytomas, cortical dysplasias, cavernous angiomas, and areas of focal atrophy are the common causes of refractory seizures. Since surgical removal of these lesions can result in complete seizure control in many patients, the patient is considered an excellent candidate for epilepsy surgery depending on the location of the lesion and its relationship to eloquent cortex. If the seizures have been present for many years then invasive monitoring is often recommended to further identify the involvement of the adjacent cortical rim around the lesion. When lesions are within the non-dominant temporal lobe, removal of the lesion along with a temporal lobectomy yields excellent results in over 80% of cases.
A lesionectomy is the surgical removal of lesions. MRI identifies small lesions as the cause of recurrent seizures in up to 25% of patients. Common types of lesions include low grade astrocytomas, cortical dysplasias, cavernous angiomas, and areas of focal atrophy.
Surgical removal of these lesions result in complete seizure control in many patients.