There are essentially two questions that the epilepsy surgery multidisciplinary team must answer before deciding whether a patient is a candidate for epilepsy surgery. The first question is: are the recurrent uncontrolled seizures originating from one brain network consistently? And, second, is this seizure network directly responsible for any important brain function?

If the answer to the first question is no, that is, the seizures are originating from many different areas of the brain, or are not localizable to one area, or originate throughout the brain all at once, then cranial resection is not possible.

In those cases the patient may be a candidate for Vagus Nerve Stimulation, corpus callosotomy, multiple subpial transections, or some other resection that is meant to be palliative rather than curative. By palliative it is meant that the surgical treatment will improve the patient's seizure control but not completely control the seizures.

If the answer to the first question is yes, then the second question becomes most important. We must be certain that the seizure network can be surgically altered safely.

Epilepsy surgery is the use of neurosurgical techniques to alter the epileptic network by removing it, disconnecting it, or otherwise changing it. The epilepsy network is surgically altered decreasing its ability to manifest the seizure process.

For many people who undergo surgical approaches, the network is altered just enough so that no brain dysfunction occurs, and the seizures become completely controlled with medication, where as, prior to the surgery the seizures were not controlled with medication.