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The cerebral cortex of the brain is divided into sections, or lobes, including the frontal, parietal, occipital and temporal lobe. The cortex is the outer layer of the brain often described as the folded, wrinkly looking tissue. It is also the largest part of the brain and controls higher thought, speech and decision making.
A temporal-parietal-occipital disconnection surgery removes the front portion of the temporal lobe and disconnects the occipital and parietal lobes. The removed and disconnected lobes are all contained to one side of the brain, leaving the frontal lobe unaffected.
- Is my child a candidate?
- What testing is needed before surgery?
- How is the surgery performed?
- What are the results of the surgery?
If your child is experiencing seizures that originate in one side of the brain, neurosurgeons may recommend temporal-parietal-occipital disconnection in the side of the brain where seizures have been shown to start.
- Before surgery, the exact location of the brain where the seizures originate from will need to be identified. This may include:
- MRI: An MRI uses large magnets, radio waves and a computer to make images of the inside of the body.
- CT scan: This test uses a series of X-rays and a computer to create images of the inside of the body. A CT scan shows more detail than a regular X-ray.
- EEG (outpatient): This test records the brain's electrical activity through sticky pads (electrodes) attached to the scalp.
- EEG (inpatient): Some patients may require a longer EEG to record electrical activity in which case a stay in the epilepsy monitoring unit will be required.
- MEG scan: MEG, or magnetoencephalography, is a noninvasive test used to localize seizures and abnormal activity within the brain using magnetic sensors. MEG can also be used to localize areas of the brain that control motor, sensory and language.
- Patients will undergo general anesthesia prior to surgery. The surgeon will then make an incision over one of the ears, behind the hairline, remove a small portion of the skull. Surgery typically lasts four to six hours. After surgery, patients will spend two to three days in the pediatric intensive care unit and return to normal activity within one to two weeks.
- Complications can happen during any surgery and there is no cure for epilepsy. Temporal-parietal-occipital disconnection surgeries are typically successful with 40-60% of patients remaining seizure free for months, years and even decades.