If surgery is right for treating your child's epilepsy, UPMC Children's Hospital of Pittsburgh uses a range of techniques.
Our Epilepsy Surgery Program experts focus on helping your child enjoy a seizure-free life so they can achieve their goals.
Minimally Invasive Techniques
Stereo-EEG using ROSA® robotic system to treat your child's epilepsy
Before epilepsy surgery, it's vital to pinpoint the part of the brain where the seizure is coming from (seizure focus).
Often, we can learn this through an MRI or EEG.
If not, your child may need to have a stereo-EEG to find the seizure focus. This involves placing thin wires into the brain for seizure mapping.
The ROSA robot:
- Helps our neurosurgeons be more precise when they do minimally invasive techniques.
- Takes 3D pictures of the brain, which we can view from any angle and depth.
- Provides a detailed roadmap of the brain's vital structures, much like a GPS system.
- Marks the exact places in the brain where we need to reach.
We then use ROSA's robotic arm as a guide to do precise surgery.
Using very thin recording wires, we access the brain through tiny drill holes. This is much less invasive than the standard approach which requires having to remove a part of the skull.
In epilepsy surgery, we guide the placement of the wires through pre-planned pathways learned by ROSA's brain mapping. Then, we use the robot's arm to guide needle-thin tools to find where seizures occur in the brain.
Laser ablation to treat your child's seizures
Using laser ablation, we treat seizures with heat.
Guided by MRI, we direct a laser fiber through a small hole in the skull to the seizure's source. We then use heat from the laser to destroy the abnormal brain tissue causing the seizures.
The MRI displays thermal maps, which outline the supply of heat in real time to ensure safety and success.
UPMC Children's Hospital has one of the most experienced laser ablation centers in the U.S., particularly for kids needing callosotomy.
More Epilepsy Treatments We Offer at UPMC Children's Hospital
Resection of seizure focus
Using a mix of brain mapping before and during surgery, we remove the part of the brain causing seizures. This is the most common type of epilepsy surgery.
It gives complete seizure relief for 50 to 90% percent of people.
This technique may also work if your child's epilepsy is:
- In a part of the brain other than the temporal lobe.
- Beyond surgery.
Callosotomy
The corpus callosum is a tract of tissue that connects the left and right sides of the brain.
A corpus callosotomy cuts this tissue to unlink the two sides of the brain.
It's not a cure but can help reduce how often seizures occur and how severe they are.
Hemispherotomy
This technique may help if your child's seizures don't respond to drugs and start from one half of the brain.
With hemispherotomy, we detach the outer layer (cortex) of one half of the brain from the other half. This prevents seizures from spreading to the healthy side of the brain.
Neurostimulation
Neurostimulation treats epilepsy when seizures don't respond to medicine, or when surgery isn't an option or helpful. The goal of using this technique is to reduce seizures and their effects.
UPMC Children's offers three types of neurostimulation:
Vagus nerve stimulation (VNS)
The vagus nerve is one of the many highways that carry messages to and from the brain. Because it connects to many regions in the brain, this nerve can be a key target for treating seizures.
During VNS, we:
- Wrap a thin wire around the vagus nerve on the left side of the neck.
- Connect the wire to a pulse generator that we implant under the skin near the collarbone.
The generator sends mild electrical impulses up the nerve at steady intervals. This changes the brain's electrical activity and lessens seizures.
Deep brain stimulation (DBS)
For DBS, we:
- Implant two thin wires into the parts of the brain related to the seizure network.
- Connect the wires to a pulse generator implanted under the skin near the collarbone.
The generator sends mild and steady electrical pulses through the wire to the brain. This alters electrical activity of the brain to reduce seizures.
Responsive neurostimulation using the RNS® System
When seizures start in a part of the brain we can't remove, your child may find relief from responsive neurostimulation.
The implanted RNS System is a small, battery-powered smart device that:
- Senses and responds to seizures in real-time.
- Sends small electrical pulses to the source of the seizure.
- Can return brainwaves to normal before they cause a seizure.
We place wires from the device on the surface of the brain, within the brain, or both.
