Childhood Seizure Treatment: Focal Cortical (Brain) Resection

What is Focal Cortical (Brain) Resection?

Focal cortical resection is a surgical treatment for focal seizures in children that can be done when brain imaging tests show that your child’s seizures begin in a single area of the brain. Brain mapping can isolate this area of the brain.

A focal cortical resection is surgery to remove the part of the brain causing the seizures. It is also called focal resection, since the total lobe is usually not removed and small parts of more than one lobe may be removed during the surgery.

What to Expect Before Focal Cortical (Brain) Resection Surgery

Children are usually given a general anesthesia prior to the surgery. To prepare for the surgery, part of your child’s hair will be shaved.

What Happens During Focal Cortical (Brain) Resection?

A surgeon will make an incision and remove part of the skull (a "craniectomy"). The exposed part of the brain will be examined. EEG recordings may be done directly from the brain surface to more precisely define the extent of the seizure activity. The portion of the brain where the seizures originate will then be removed. The skull piece will be replaced, and the scalp will be sutured. A sterile head dressing will be applied and your child will be transferred to the Intensive Care Unit (ICU). The surgery typically takes about four hours.

What to Expect After Focal Cortical (Brain) Resection Surgery

Your child will be in the ICU under constant observation until he is medically able to return to another nursing unit, usually within one to two days.

Minor side effects of focal (brain) resection surgery in children may include:

  • Possible swelling
  • Black eye
  • Headache
  • Mild jaw pain

Within 24 hours your child will be able to start sitting up and drinking. Seizure medicine will continue after surgery, but the dosage may be different than prior to surgery. Discharge is usually five to seven days after the surgery.

Potential Complications of Focal Cortical Resection Surgery in Children

As with any surgery, there is a potential for complications. The risk with focal cortical resection is very low. However, it is important to understand that if complications arise, they may be serious. The major problems that could develop are bleeding and infection.

Please be sure to inform your child’s surgeon if your child has any tendency toward bleeding complications or is taking medications such as aspirin, ibuprofen or Depakene®, since these drugs can affect bleeding.

Contact the Epilepsy Center

To make a referral, schedule an appointment, or request an evaluation for a child or teen, call at 412-692-6928.