Remote Assessment: Are You a Surgical Candidate?
Epilepsy surgery comes into consideration for patients whose seizures persist despite adequate trials of at least two appropriate medications (drug-resistant). Before undertaking a cross-border journey, you can request an online preliminary assessment by digitally sharing your brain MRI, EEG/video-EEG reports and a list of your medications via WhatsApp. At this stage the aim is to discuss honestly whether surgery is genuinely an option for you and which additional tests would be needed. For some patients a medication adjustment or a remote opinion alone is informative; for others, further investigation is recommended.
Epilepsy Surgery Is Not a Single Operation
Surgical options vary with the location and type of the seizure focus: one of the most common is the focal resection performed in temporal lobe epilepsy; if the focus is in another lobe, a lesionectomy or lobar resection may be done. When the focus cannot be safely removed, disconnection procedures aimed at limiting seizure spread, or non-resective options such as vagus nerve stimulation (VNS) and other neuromodulation methods come into play. Which method is appropriate is determined not by a single MRI but by evaluating imaging, EEG and neuropsychological testing together.
The Process in Turkey: Imaging and Locating the Focus
If the remote assessment suggests surgery is possible, the advanced tests required and the estimated length of stay are planned before you arrive in Turkey. Here a high-resolution epilepsy-protocol MRI, video-EEG monitoring, and mapping of language/memory areas with functional MRI when needed are performed; in selected cases PET or invasive electrode studies may be added. All data are discussed with a multidisciplinary team (neurology, neurosurgery, neuroradiology, neuropsychology). The goal is for the area to be removed to be sufficient to stop seizures, yet limited enough to preserve critical functions such as speech, memory and movement.
Surgery and the Recovery Journey
If surgery is found appropriate it is usually performed under general anaesthesia; for foci near a speech or movement area, awake surgery and intraoperative mapping are used when required. Duration and technique vary by case. After surgery there is usually a period of intensive care and a few days of hospital stay; antiepileptic medication is continued for a time after surgery under medical supervision — even a successful operation usually does not mean stopping medication immediately. At discharge, a written summary is prepared for the seizure diary, the medication plan and the neurology follow-up to be continued in your home country.
Honest Expectations and Multilingual Communication
The aim of epilepsy surgery is to reduce the seizure burden or, where possible, achieve seizure freedom; the outcome varies from patient to patient depending on the location and type of the focus, and no result can be guaranteed. Risks (changes in memory, language or visual field, infection, bleeding) are discussed openly. For a patient coming from across a border, the most critical point is that these expectations and risks are clearly understood in their own language; communication is kept open and clear from start to finish. The decision is made together with you after all your data have been seen.