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Pediatric Epilepsy Surgery

Is Surgery Right for Your Child with Epilepsy?

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Our team of highly specialized providers at the Orlando Health Children's Neuroscience Institute offers a variety of treatments can significantly cure the source of seizures or reduce their frequency and severity. For many children with drug resistant epilepsy, medications provide adequate control of seizures. But for nearly a third of U.S. children with drug-resistant epilepsy, medications will not be a cure and most will benefit from surgical intervention.

Surgery may be suggested if your child’s seizures are not adequately controlled through medications. If your child's seizures are not controlled with medications, we will carefully study your child’s unique condition and needs to see if they are a good candidate for surgery.

We offer all of the latest treatments and most advanced procedures available for treating all types of seizures, including generalized, focal, multi-focal, drop attacks and gelastic seizures, etc. Our clinical expertise spans the entire range of all known effective treatments, including, laser ablation, robotically assisted surgeries and precision implantation of neurostimulators.

We understand that making the decision to have epilepsy surgery for your child can be very difficult. Our compassionate team will help you understand the risks and benefits and will be by your side – before, during and after the surgery. For many children, surgery will be a permanent cure for their epilepsy. And even when that isn’t the case, the severity and frequency of seizures should be significantly reduced, improving the quality of life dramatically.

Diseases and Conditions

Epilepsy from any cause, is likely an excellent reason for epilepsy surgery. We care for all patients with the following:

Tuberous sclerosis complex is a genetic condition that causes the development of small non-cancerous growths (tubers) in the brain. Most children with this condition will begin experiencing spasms or seizures during their first year. For at least half of these children, medications alone will not be enough to control the seizures. Ketogenic diets and vagal nerve stimulation may also help.

Surgery may be an option if the seizures can be traced to one or more of the tubers. Removing the tubers, along with some surrounding tissue, can be an effective way to permanently stop the seizures. Fortunately, imaging advances are increasing our ability to identify and pinpoint the troublesome tubers.

Focal cortical dysplasia affects the outermost layer (known as the cerebral cortex) of your child’s brain. This is the area of the brain that controls movement, thoughts, speech, memory, intelligence and personality. The genetic condition causes abnormal groups of cells, or lesions, to form. The resulting seizures often do not respond to medications, making them the most common reason for epilepsy surgery.

Effective surgical treatment requires the most advanced imaging techniques available to accurately map the area of the brain affected by the dysplasia. Younger children and infants are more likely to require more extensive surgeries because their abnormalities (cortical dysplasia type II) tend to be more extensive. Surgery provides a permanent fix for seizures in at least 60 percent of children. Your child may also experience improvements in behavior, attention, development and cognitive skills.

Hemimegalencephaly is a rare genetic condition that causes half of your child’s brain to be abnormally large. It can cause malformations in parts of the brain, which can lead to seizures. These seizures are rarely able to be controlled through medication and can create significant developmental delays if not treated.

For many children, surgery is the best option. This highly specialized treatment disconnects the affected brain hemisphere. The disconnected hemisphere may be left in the skull or removed, depending on the severity of the condition.

Rasmussen’s encephalitis is a very rare brain condition that causes inflammation (encephalitis) in half of your child’s brain. This inflammation grows worse over time, causing frequent seizures that can leave permanent brain damage. It can lead to paralysis, loss of sensation, weakness on one side of the body and mental decline. It most often shows up in children between the ages of 4 and 12 years.

These seizures do not typically respond to medication. Instead, controlling the seizures often requires surgery to disconnect or remove the inflamed brain hemisphere.

Lennox Gustom Syndrome (LGS) is a rare and severe form of epilepsy that typically develops in early childhood and is characterized by multiple types of seizures that can be difficult to control. Children with LGS may also experience developmental delays, learning difficulties and challenges with behavior. Although seizures can be challenging to manage, treatment options such as medications, dietary therapies and epilepsy surgery may help reduce seizure frequency and improve quality of life.

Post traumatic epilepsy is a type of epilepsy that can develop after a child experiences a traumatic brain injury. Seizures may occur weeks, months or even years after the injury and can vary in type and severity. Treatment may include anti-seizure medications, dietary therapies or epilepsy surgery, depending on the child’s seizures and individual needs.

Sturge-Weber syndrome (SWS) is a rare genetic vascular disorder that causes blood vessels to grow abnormally in your child’s brain, skin and eyes. The most visible characteristic is a port wine stain birthmark on the upper portion of one side of your child’s face. This skin lesion is usually there at birth but can change in size and appearance as your child grows.

Birthmarks are far more common than Sturge-Weber. So having a similar birthmark does not mean your child will experience any additional symptoms. But for some children, the vascular disorder can cause malformations in blood vessels in the brain, which can lead to seizures and vision issues. Seizures are often controlled through medication, but surgery may be suggested for children whose seizures do not respond well to medication.

Pre-Surgical Evaluation

A seizing brain isn’t a developing brain, and at the Orlando Health Children's Neuroscience Institute, our #1 priority is always the safety of the child and to allow the child to be more of themselves and not less. We understand that surgery is a big step for your family. Our multidisciplinary team will work with you to make sure this is the right decision for your child to treat drug-resistant epilepsy. Our compassionate neurosurgeons, epileptologist, imaging specialists, neuropsychologists, anesthesiologists and geneticists are here to help you and your family explore and understand your options.

Before offering surgery as an option, we will perform a thorough evaluation to make sure your child is a strong candidate. The evaluation will start with an exploration of the history of your child’s seizures and medications. From there, we will incorporate advanced imaging as well as often prolonged video EEG sessions to help identify the area of your child’s brain where the seizures begin. Based off these results, there are additional specialized imaging procedures that can help us develop an optimal plan for your child...including: PET Scan, SPECT/SISCOM, MEG, Functional and Resting State MRIs, etc. Psychological and formal neurological testing to better characterize the effects of epilepsy of your child and location of the brain will also be used to help determine if surgery is the right choice.

Both throughout and following the evaluation, our team, including an epileptologist and neurosurgeon, will meet with your family to discuss a treatment plan that offers the best opportunity to eliminate or improve your child’s seizures.

Surgical Procedures

The Orlando Health Children's Neuroscience Institute offers all of the latest and most advanced surgical treatments available for epilepsy. Our pediatric neurosurgeons have additional fellowship training in minimally invasive neurosurgery and are often able to achieve the desired results through outpatient procedures such as laser ablation. This reduces post-operative pain, days spent in the hospital and risk of infection, while also improving outcomes.

It is important to know that the anesthesia needs of children are different than those for adults. That’s why we have a team of dedicated pediatric anesthesiologists who specialize in minimizing pain for children during and after their surgeries. Combining the skills of our world-class neurosurgeons and anesthesiologists, we can provide a wide range of procedures for children of all ages. These include:

  • Robot-assisted stereoelectroencephalography (sEEG) is a minimally invasive procedure that allows our surgeons to insert tiny electrodes that help map your child’s brain and pinpoint the source of drug-resistant seizures.
  • Laser ablation surgery is a minimally invasive procedure that uses the heat from a laser to destroy brain tissue responsible for seizures.
    • Clear Point – navigation platform that allows us to accurately place the laser platforms in real time during an MRI, which is performed in an MRI suite
  • Craniotomy to open epilepsy is an open surgical procedure used to disconnect parts of your child’s brain that are causing seizures.
  • Deep brain stimulation (DBS) involves implanting electrodes that help regulate abnormal brain activity. This can be helpful for children with multifocal generalized epilepsy.
  • Unlocking Hope: Deep Brain Stimulation with Dr. Ryan Jafrani
  • We Make It Personal - Deep Brain Stimulation
  • Vagus nerve stimulation (VNS) is accomplished by implanting a small device under the skin and attaching it with electrodes to the vagus nerve in your child’s neck. Stimulating this nerve can help reduce additional epilepsy procedures.
  • Functional hemispherectomy is a type of epilepsy surgery that disconnects most or all of the connections between one side of the brain and the rest of the brain. It may be considered for children with severe, drug-resistant seizures originating primarily from one hemisphere.
  • Corpus callosotomy is a surgery that disconnects the corpus callosum, the structure that connects the brain’s two hemispheres. It may help reduce the spread and severity of seizures, particularly dangerous drop attacks, in children with difficult-to-control epilepsy.
  • Lesionectomy or tuberectomy removes a specific area of abnormal brain tissue that is causing seizures, such as a lesion or cortical tuber. The goal is to remove or disconnect the seizure-producing tissue while preserving as much healthy brain tissue as possible.

Epilepsy Surgery FAQs


Epilepsy is a fairly common disorder that sparks abnormal electrical surges in your child’s brain, creating seizures. Not all seizures indicate epilepsy. A diagnosis usually follows two or more seizures that were not provoked by other events.

Epileptic seizures can be controlled with medication. Epilepsy is considered “drug resistant” if seizures continue even after your child has tried at least two different anti-seizure medications.

Yes. If seizures aren’t controlled, they can impact your child’s development, including learning and emotional well-being. A seizing brain isn’t a developing brain.

Epilepsy surgery comes in several forms, but they have the same goal: To eliminate or reduce seizures by modifying, disconnecting or removing the part of the brain that is causing them.

At Orlando Health Children’s Neurosurgery Institute, we perform every type of pediatric epileptic surgery available, some of which include:

  • Resection or laser ablation is used to target abnormal brain tissue responsible for the seizures.
  • Hemispherotomy is a procedure that disconnects the troublesome brain hemisphere from the rest of the brain.
  • Corpus callosotomy is used to partially disconnect the brain’s hemispheres. This can help with seizures (drop attacks) that cause your child to fall to the ground.
  • Implanted neuromodulation devices can help regulate electrical activity in your child’s brain. These include responsive neurostimulation (RNS), deep brain stimulation (DBS) and vagus nerve stimulation (VNS).

A careful evaluation by our epileptologist and neurosurgeons, using the most advanced imaging and diagnosing available, we will assess your child’s surgery prospects. After mapping your child’s brain and unique epilepsy pinpointing the source of seizures, our team will discuss the options that offer your child the best possible outcomes.

No, our goal is to keep your child safe. A seizing brain isn’t a developing brain, and we strive to optimize your child’s developmental potential. Surgery should never be a last resort, rather a necessary part of the treatment plan.

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