UC Davis Epilepsy Surgery Program
Surgery in Epilepsy
Epilepsy is a medical condition characterized by recurrent seizures. Most seizures can be controlled with medications, but about one-third of patients continue to have seizures despite the best medical therapy. This is called "refractory" epilepsy. In these cases, surgery may be an option.
Who should see an expert?
The National Association of Epilepsy Centers recommends that:
- Any patient with recurrent seizures for more than 3 months should be evaluated by a neurologist.
- Patients being managed by a neurologist, who continue to have seizures after one year of medical management, should be referred for epilepsy surgery consultation.
Several tests may be required to determine whether someone with epilepsy is a surgical candidate. These include:
- Brain imaging studies, such as MRI, PET, and SPECT scans
- Video EEG, a brain wave test combined with video monitoring where electrodes are placed on the scalp and patients are monitored in the hospital for several days
- WADA test, to help determine which side of the brain is dominant for language and memory
- Neuropsychological assessment, to understand how the brain is functioning now and how surgery might affect it
An Expert Team
Several specialists are involved in determining if patients might benefit from surgery. The UC Davis comprehensive epilepsy team includes neurosurgeons, neurologists, and neuropsychologists with extensive experience and subspecialty fellowship training in epilepsy surgery. A team of surgeons and specialists are often present in the operating room during surgery to ensure that our patients receive the best care.
Approach to surgery
UC Davis offers some of the latest surgical techniques to treat epilepsy. Sometimes surgery is done to help us understand where the seizures are coming from. EEG wires, or electrodes, may be placed in or on the surface of the brain to detect the seizure activity. These are placed in the operating room under sterile conditions, often using minimally invasive techniques.
Knowing where the seizures are coming from determines if epileptic surgery is a treatment option or cure for the type of seizures. If surgery is an option, we will review all of the potential risks and benefits with you so that you can decide if it’s right for you.
The most common types of surgery include removal of abnormal tissue from the brain (resection), making small cuts through part of the brain (transection) or disconnecting a larger portion of the brain. In some cases, patients are awake for a portion of the surgery (known as an awake craniotomy), in order to map important areas of the brain and make the surgery as safe and effective as possible.
If the seizures are coming from several places in the brain, patients may still benefit from new medical devices and stimulators that send signals to the brain to reduce seizures. These FDA approved devices include Neurostimulators (NeuroPace or RNS) placed in the head, or Vagal Nerve Stimulation (VNS) placed in the left neck.
UC Davis is one of a handful of Level 4 epilepsy centers across the country. This means we provide the most complex form of neurodiagnostic monitoring, medical and neuropsychological treatment, and a broad range of surgical procedures for the diagnosis and treatment of epilepsy. In addition, we have numerous research studies underway to advance the understanding of this complex disease and improve treatments for all types of epilepsy.
Nationally recognized expertise
Named one of the best regional hospitals in the country for neurology and neurosurgery by US News and World Report for several years running, UC Davis offers patients the latest treatments for neurological disorders.
The Departments of Neurology and Neurological Surgery at UC Davis Health are home to internationally recognized experts in neurological disorders – including a highly experienced multidisciplinary team of physicians, surgeons, nurses and researchers – who utilize state-of-the-art technologies combined with compassionate care to provide the most current and effective treatments for patients.
Referring a Patient
To refer a patient to the Epilepsy Surgery Program at UC Davis, please call the Physician Referral Center at 800-4-UCDAVIS (800-482-3284) and selection option 3.
The UC Davis surgical epilepsy team will partner with you to determine if surgery is an option. Once any consultations or surgical procedures are complete, patients will return to their regular neurologist for ongoing care.
Surgical Epilepsy Program
Fady Girgis, M.D., Ed.M., FRCSC, Neurosurgeon
Kia Shahlaie, M.D., Ph.D., FAANS, Neurosurgeon
Marike Zwiennenberg, M.D., FAANS, Neurosurgeon, pediatrics
Masud Seyal, M.D., Neurologist
Jeff Kennedy, M.D., Neurologist
Inna Kesselman, M.D., Ph.D., Neurologist
Celia Change, M.D., Neurologist, pediatrics
William Benko, M.D., Neurologist, pediatrics
Shannon Liang, M.D., Neurologist, pediatrics
Sarah Farias, Ph.D., Neuropsychologist
Katherine Denny, Ph.D., Neuropsychologist
Matthew Bobinski, M.D., Ph.D., Neuroradiology
Jennifer Chang, M.D., Neuroradiology
Richard Latchaw, M.D., F.A.C.R., Neuroradiology
Brian Dahlin, M.D., Interventional neuroradiology
Nina Schloemerkemper, M.D., Neuroanesthesiology
Sophia Yi, M.D., Neuroanesthesiology