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The Northern Children’s Epilepsy Surgery Service (NorCESS) is a joint service between Alder Hey and Royal Manchester Children’s Hospital. It is one of only four national centres offering an epilepsy surgery and rehabilitation service.
Our team has a great deal of experience in treating children with neurological conditions, and whilst an epilepsy surgery service is fairly new, it’s proven to be very successful. We operate on the brain to try to reduce seizures or even cure your child’s epilepsy, and generally we see these results in 50-75% of patients. This service combines surgical expertise and specialist rehabilitation services, ensuring all patients get the very best care.
We believe that surgery can be an excellent option for many epilepsy patients and we want to help as many children as possible. Your GP or healthcare specialist may refer your child to us when:
Epilepsy surgery is an operation on the brain (called a neurosurgical operation) to try to stop or reduce the number of your child’s seizures (also called fits). Surgery is the only thing that might actually cure your child’s epilepsy.
There are different types of epilepsy surgery that can be done, and the type of operation will depend on your child’s epilepsy.
Surgery will be considered if:
After talking with your Neurologist and Neurosurgeon your child may need further tests before any surgery can be considered.
They will need a special type of EEG called video-telemetry, an MRI brain scan and probably a neuropsychology and psychiatry assessment. The neuropsychology test assesses your child’s concentration, short-term memory and learning abilities, and the psychiatry assessment assesses your child’s feelings and mood.
Based on the results of these detailed tests, your child’s Neurologist and Neurosurgeon will then talk with you about whether your child is suitable for epilepsy surgery, as well as the type of surgery and all the possible risks and benefits.
Having any kind of surgery on the brain is a big decision to make. You will probably have many questions or concerns that you will want to discuss before you are able to make a decision. The Neurologist and Neurosurgeon will always answer your questions and will help you to make a decision.
This depends on the underlying cause of your child’s epilepsy, where the seizures are coming from and the type of surgery they may undergo. Generally, 50% to 75% of those who have epilepsy surgery will have their seizures stopped or greatly reduced. The results are better if your child’s seizures come from the part of the brain called the temporal lobe.
Alder Hey is a specialist children’s hospital which means your child can have all their tests and their epilepsy surgery here. There are a number of different types of surgery for epilepsy. The type of surgery will depend on your child’s epilepsy. The most common type of surgery is the removal of a small part of the brain which is the underlying cause of the epilepsy. This part is usually called the ‘focus’. It is sometimes called the ‘lesion’ –which is the medical word for abnormality. These are our procedures:
Your child will be usually be admitted to the Neurosurgical ward at Alder Hey the day before the operation. The nurses will ask your details, one of the doctors will ask you some questions about your child’s health, examine your child and take blood tests before the operation. An anesthetist will also examine your child to make sure they are well enough for the operation. Your child’s Neurosurgeon will explain the risks and benefits of the operation. You will then be asked to sign a consent form to say you have agreed for the operation to take place.Please bring all of your child’s medication with you when you come to hospital.
When it is felt that your child is well enough, they will be allowed to go home. The stitches your child has had are dissolvable so they should not need to be removed. The stitches can sometimes take up to 90 days to dissolve altogether, but if you are concerned you should ring the Neurosurgical ward at Alder Hey.
You will be given an appointment to come back and see your Neurosurgeon usually within four to six weeks after discharge.
Your child should continue to take their anti-epileptic drugs for at least six months after surgery. Your child’s Neurologist will advise you when would be the best time to start to slowly reduce your child’s anti-epileptic medication.
This will depend on your child’s operation and how quickly they have recovered. Your child’s Neurosurgeon will always advise you on this matter.
For some children, surgery will be felt to have been successful if it has completely stopped all seizures. For others, it may mean reducing the number or the severity of seizures. Usually six to nine months is needed after surgery to fully decide how successful surgery has been.
New referrals will be forwarded to the NorCESS Paediatric Neurologist on call.
Please send to:
Epilepsy Network CoordinatorNorCESS - Department of Paediatric Neurology,2nd Floor (WARD 83),Royal Manchester Children's HospitalHathersage Road,ManchesterM13 9WL
Fax: 0161 701 5382
Please be mindful of security protocol when sending patient details.
Upon accepting a referral, children are discussed at a multidisciplinary MDT where a decision will be made as to whether they are suitable for surgery or whether further investigations are needed in order for a decision to be made.
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