In this section...

  1. Acute Physiotherapy
  2. Cheshire and Merseyside Rehabilitation Network (CMRN)
  3. Chiari malformation and syringomyella
  4. Cognitive neurology
  5. Complex regional pain syndrome (CRPS)
  6. Dietetic Services
  7. Electroencephalogram (EEG)
  8. Endoscopic (keyhole) spinal surgery
  9. Epilepsy
  10. Epilepsy specialist nurse service
  11. Epilepsy surgery
  12. Essential tremor - Ultrasound thalamotomy
  13. Evoked potentials (EP)
  14. Facial pain
  15. Fluroscopy
  16. Functional Neurological Disorders Service (FNDS)
  17. Headache service
  18. Hydrocephalus, CSF disorders and spina bifida
  19. Infection prevention and control
  20. Integrated Neurology Nurse Service
  21. Interventional Radiology
  22. Major Trauma service
  23. Motor neurone disease
  24. Multiple sclerosis
  25. Multiple sclerosis (MS) nurse service
  26. Nerve conduction studies (NCS) and Electromyography (EMG)
  27. Neuroanaesthesia and Critical Care
  28. Neurogenetic disorders
  29. Neurological long-term conditions OT service
  30. Neurological Long Term Conditions Physiotherapy Team (LTC)
  31. Neurology
  32. Neuromodulation for Pain and Pelvic Floor Instability
  33. Neuromuscular disorders
  34. Neuromyelitis optica
  35. Neuro-Oncology Department
  36. Neuropathic pain (nerve pain)
  37. Neurophysiology Department
  38. Neuropsychiatry
  39. Neuropsychology Department
  40. Neuropsychology inpatient service
  41. Neuroradiology
  42. Neuroscience Laboratories
  43. Neurosurgery
  44. Neurovascular surgery and intervention
  45. Pain Management Programme
  46. Pain medicine
  47. Palliative care pain
  48. Parkinson's disease Nurse Specialists
  49. Pre-operative Assessment Team
  50. Physiotherapy botulinum toxin service
  51. Rehabilitation
  52. Research
  53. Respiratory Physiotherapy Team
  54. Speech and Language Therapy
  55. Spinal surgery
  56. Surgical management of chronic pain
  57. Surgical, Medical, Acute Response Team (SMART)
  58. Theatres
  59. Therapies Department
  60. Tissue viability
  61. Trauma Therapy Team

Epilepsy surgery

 

The Walton Centre has one of the oldest and largest epilepsy surgery services in the country. It undertakes a full range of invasive diagnostic procedures as well as therapeutic procedures.

 

Diagnosis

Surgery for epilepsy can be extremely successful but can involve a lot of complex tests and evaluations before the neurosurgeon is happy to offer the patient definitive surgery – some of these investigations themselves involve operations.

Tests involved and offered include sophisticated imaging, often with functional MRI imaging; neuropsychological assessments; video surface EEG and on occasion operations to place depth electrodes to specific targets within the brain, and grids of electrodes placed over the brain. These allow the origin of the epilepsy to be located. A subsequent goal is to assess if this area of the brain can be removed without damage brain function.

 

Surgery 

If the source of the seizures can be located and that area of the brain can be removed without injuring function, then surgery is possible.

Such procedures include:

  • Temporal lobectomy or selective procedure
  • Extra temporal removal of tissue shown to be epileptogenic
  • Hemispherectomy – in rare cases half the brain will be removed or disconnected
  • Lesional surgery
  • Tumours
  • AVMs
  • Cavernoma
  • Cortical dysplasia

If it is not possible to locate a single source of the seizures or the patient would suffer a neurological deficit as a consequence of removal of the epileptogenic brain then procedures can be carried out to modify the attacks, either their effect or to try to modify the electrical activity of the brain. Such procedures include

Awake craniotomies with neurophysiological monitoring to locate and preserve brain function, usually coupled with pre-operative functional localization by MRI – similar in principle to procedures carried out in oncology.

We perform different surgical procedures, including diagnostic testing, imaging, and surgical resections.

 

Surgical resections

  • Temporal lobectomy
  • Extratemporal resections (frontal, occipital, parietal)
  • Lesionectomy
  • Resection for epilepsy in eloquent area.

Disconnection procedures

  • Functional hemispherectomy
  • Corpus callosotomy
  • Multiple subpial transection

Neuromodulation for epilepsy

  • Vagal nerve stimulation
  • Deep brain stimulation
     

 

 

Patient leaflets

Discharge guide for patients following surgery for epilepsy

Epilepsy transition - A young person's guide

First Seizure

 

Consultants

Mr Jibril Farah