Palliative Surgical Treatment
Unlike resective (or curative) epilepsy surgery where the main goal of surgery is to eliminate further seizures, the main objective of palliative surgery is to reduce the severity and frequency of seizures and improve the patient’s quality of life. There are several non-resective (and generally non-curative) surgical treatment options for patients with refractory epilepsy. These palliative procedures include:
When resective surgery is not possible, partial corpus callosotomy can relieve generalization of seizures and eliminate injury for some patients with generalized motor, tonic or atonic seizures.
Vagal nerve stimulation (VNS)
For some patients who do not respond to medical therapy, the DMC/WSU Comprehensive Epilepsy Program offers an implantable vagal nerve stimulating device that has been shown to reduce seizure frequency and intensity.
Multiple subpial transection (MST)
MST is a non-resective surgical technique that may be used in patients whose epileptogenic zones involve an eloquent cortex, such as the primary sensorimotor cortex and the language areas. Removal of these eloquent brain regions would carry significant risks. Instead, MST preserves the vascular supply and structure of these eloquent areas, but interrupts epileptic impulses.