Surgical treatment of epilepsy

Most epilepsies are well controlled with medication. But when seizures persist despite well-conducted treatment — known as drug-resistant epilepsy — a surgical solution may be considered in certain carefully selected patients. The principle is to identify precisely the area of the brain where the seizures originate and then, when it can be removed without functional risk, to treat it surgically. This identification relies on a rigorous pre-surgical work-up: prolonged video-EEG recordings, high-resolution brain MRI and neuropsychological assessment, carried out in close collaboration between neurologists, neurophysiologists and neurosurgeons. The operation itself is performed under the microscope, guided by neuronavigation and secured by intraoperative neurophysiological monitoring. The goal is a major reduction, or even complete disappearance, of the seizures, resulting in a transformation of quality of life. At Clinique Pasteur Tunis, this care relies on close collaboration between the neurosurgery department and the clinic's neurophysiological exploration center, which performs the pre-surgical video-EEG work-ups and the intraoperative monitoring.