Surgery of the brain performed on the internet

Temporal lobectomy, a surgical procedure that involves removing parts of the temporal lobe that cause seizures, is offering hope to epilepsy patients who have not been responsive to medical therapy.

Neurologists and neurosurgeons at Wake Forest University Baptist Medical Center use electroencephalograms (EEG), positron emission tomography (PET) and magnetic resonance imaging (MRI) in the state-of-the-art Epilepsy Monitoring Unit (EMU) to pinpoint the exact origin of the disease. Surgeons then remove the scarred tissue to reduce or eliminate the seizures.

On Wednesday March 1 at 5 p.m. neurosurgeon Steven Glazier, M.D. will perform a temporal lobectomy during a live Internet broadcast. The surgery removes a small part of the temporal lobe, part of the brain that extends from the temples to just past the ears.

"Patients must have failed at least one standard and one new medication to be considered for surgery," he said.

"We are working in high-risk territory so we use imaging tests to carefully pinpoint the origin of the seizures so that we make sure we leave the pathways for speech, movement and memory intact," said Glazier, M.D. "Eighty percent of patients are cured with this procedure and ninety-five percent have a dramatic reduction of their seizures. It adds a tremendous amount to their quality of life." About 15 to 30 temporal lobectomies are performed each year at the medical center.

The Comprehensive Epilepsy Center at Wake Forest Baptist provides Level IV care -- the highest level of care available. Full-time epileptologists, a neurosurgeon experienced in epilepsy surgery, nurse clinicians, social workers, pharmacists and neuropsychologists work with patients and their families to help diagnose and treat the disease, which affects about one percent of the population.

With its comprehensive approach to care, Wake Forest Baptist houses the only program in North Carolina to meet the guidelines of the National Association of Epilepsy Centers for top-level medical and surgical centers.

Researchers at the medical center are working to find a cure for the disorder and their patients benefit from a variety of treatment options.

"Just 10 years ago seizure-free living was unthinkable for many people with epilepsy," Glazier said. "Today that can be achieved even in difficult-to-control cases."