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contact sports, heavy lifting and swimming only after surgeon clearance and seizure-safety review."},"final_result_months":{"min":12,"max":24,"unit":"months","qualifier":"Seizure outcome is usually judged 1-2 years after surgery; medication taper decisions are individualized."},"fly_home_after_days":{"min":10,"max":14,"unit":"days","qualifier":"After uncomplicated craniotomy, once neurosurgeon confirms stable neurological status, wound check and no seizure or CSF leak concerns."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":10,"max":14,"unit":"days","qualifier":"Wound check and suture or staple removal."}},{"purpose":"assessment","requirement":"routine","after":{"min":60,"max":120,"unit":"days","qualifier":"Neurological review, seizure diary and medication review; often repeat MRI."}},{"purpose":"result_review","requirement":"routine","after":{"min":365,"max":730,"unit":"days","qualifier":"Seizure outcome and neuropsychological reassessment."}}],"indications":["Drug-resistant focal epilepsy (failure of two appropriately chosen antiseizure medications)","Well-localized resectable focus, such as mesial temporal sclerosis","Structural lesion causing epilepsy (e.g. tumor, cavernoma, focal cortical dysplasia)","Disabling seizures with concordant presurgical findings (video-EEG, MRI, neuropsychology)"],"main_risks":["Visual field deficit (e.g. superior quadrantanopia after temporal resection)","Memory or language decline, especially with dominant-hemisphere surgery","Infection, bleeding or stroke","Cerebrospinal fluid leak or hydrocephalus","Mood changes, depression or anxiety","Focal neurological deficit depending on resection site","Anesthesia-related risks"],"pain":"Moderate headache and incision or jaw pain in the first days, controlled with oral or intravenous analgesia; usually settles within 1-2 weeks.","preparation":["Presurgical video-EEG, MRI, neuropsychology; often PET/SPECT or intracranial EEG","Multidisciplinary epilepsy surgery team review and informed consent","Preoperative blood tests and anesthetic assessment","Review all medicines; continue antiseizure medication","Fasting before surgery as instructed","Arrange support at home and discuss driving restrictions"],"recovery_timeline":[{"phase":"Hospital stay (days 0-7)","description":"Neurological monitoring, pain control, early mobilization and continued antiseizure medication.","restrictions":["No driving","Stay under supervision"]},{"phase":"Early home recovery (weeks 1-6)","description":"Fatigue, headache and wound healing; gradual increase in walking and daily activities.","restrictions":["No driving","No heavy lifting or strenuous activity","Avoid swimming and bathing alone"]},{"phase":"Return to activity (weeks 6-12)","description":"Return to work or study and graded exercise as cleared; cognitive and mood follow-up.","restrictions":["Follow local driving rules after seizure-free interval","Avoid contact sports until cleared"]},{"phase":"Long-term follow-up (months 3-24)","description":"Seizure outcome assessment, imaging, neuropsychology and decisions on medication tapering.","restrictions":[]}],"rehabilitation_days":{"min":30,"max":90,"unit":"days","qualifier":"Ordinary functional recovery after resective surgery such as temporal lobectomy; formal therapy only if a deficit exists."},"result_longevity":"Seizure freedom after resective surgery is often long-lasting, with roughly 50-70% of temporal lobe cases seizure-free at 5 years. Late relapses occur in some patients; durability depends on epilepsy type, lesion and completeness of resection.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Repeat resective surgery for persistent or recurrent seizures within several years; rare early reoperation for bleeding or infection."},"scars":"Curved or linear scalp incision, usually in the hairline or behind it, healing to a thin scar largely hidden by hair; temporary shaved area possible.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One resective operation after completed presurgical evaluation; invasive monitoring, when needed, is a separate preceding stage."},"stages":[{"code":"resection","label":"Resective surgery (e.g. anterior temporal lobectomy) under general anesthesia","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery."}}],"qualifier":"Typical single-stage resection; follow-up checks are not counted as treatment sessions."},"success":{"metric":"Seizure freedom after temporal lobe resection","value":65,"unit":"percent of patients","horizon":"1-2 years after surgery","population":"Adults with drug-resistant mesial temporal lobe epilepsy and concordant presurgical findings","evidence_status":"limited"},"techniques":[{"name":"Anterior temporal lobectomy with amygdalohippocampectomy","suits_whom":"Drug-resistant mesial temporal lobe epilepsy","recovery":"Hospital stay about 3-7 days; return to work about 6-12 weeks."},{"name":"Lesionectomy or focal cortical resection","suits_whom":"Epilepsy from a defined lesion (tumor, cavernoma, dysplasia) outside critical cortex","recovery":"Similar to craniotomy; hospital stay about 3-7 days."},{"name":"Laser interstitial thermal therapy (LITT)","suits_whom":"Small deep focus such as mesial temporal sclerosis or hypothalamic hamartoma","recovery":"Shorter stay, often 1-2 nights; faster return to activity."},{"name":"Disconnective surgery (corpus callosotomy, hemispherotomy)","suits_whom":"Selected drop-attack seizures or widespread unilateral damage, often in children","recovery":"Longer inpatient stay; individualized rehabilitation."},{"name":"Vagus nerve stimulator implantation (palliative)","suits_whom":"Drug-resistant epilepsy not suitable for resection","recovery":"Day case or 1 night; return to normal activity in days to 2 weeks."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":3,"max":6,"unit":"hours","qualifier":"Operating time for a single resective craniotomy such as anterior temporal lobectomy; excludes anesthesia preparation and recovery."},"initial_assessment_documents":["Brain MRI epilepsy protocol on disc","Video-EEG monitoring report","Neurologist's epilepsy summary letter","List of tried antiseizure medications and doses","Neuropsychological testing report (if available)"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single resective operation after remote review; 10-14 days stay. Second trip only if invasive monitoring or in-person evaluation needed first."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that you can ask the treatment team questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that you are satisfied with the facilities and standards at the clinic or hospital","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check how your aftercare will be coordinated before you go ahead","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Check that the surgeon you consult will be the person carrying out the procedure","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Ask for examples of the practitioner’s experience with the surgery you plan to have","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Ask for examples of the practitioners’ experience with the surgery you are intending to have.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C7","text":"Check that a face-to-face consultation with the operating health professional takes place before any procedure","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"A face-to-face consultation with the health professional who will carry out any planned surgery or treatment must take place before any procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Pressure to decide quickly or accept a cheap, time-limited offer","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"The surgeon you consult may not be the person who operates","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"Surgery offered as a package combined with holidays","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Be wary of package deals which combine surgery with holidays – any decision to have surgery should be taken based on medical reasons only.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F4","text":"A hard sell, or no discussion of possible complications before booking","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Weakness and speech impairments","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/5015-epilepsy-surgery","host":"my.clevelandclinic.org","quote":"Brain tissue damage, resulting in neurological changes (like weakness and speech impairments) or stroke.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Delayed healing at the surgical site","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/5015-epilepsy-surgery","host":"my.clevelandclinic.org","quote":"Delayed healing at the surgical site.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Severe pain after surgery","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/5015-epilepsy-surgery","host":"my.clevelandclinic.org","quote":"But let your provider know if the pain is severe or if you experience any additional symptoms.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Home doctor needs the medicines given to continue treatment","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"Home doctor needs imaging to compare and follow up care","document":"scans and x-ray copies","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T3","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T5","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your epileptic focus can be monitored with an implanted device","name":"Responsive neurostimulation","source":{"url":"https://my.clevelandclinic.org/services/epilepsy-seizures-treatment","host":"my.clevelandclinic.org","quote":"RNS involves a device that’s implanted in your brain near where the epileptic focus is and continuously monitors brain waves.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A2","text":"Your abnormal brain waves may occur far from one area","name":"Deep brain stimulation","source":{"url":"https://my.clevelandclinic.org/services/epilepsy-seizures-treatment","host":"my.clevelandclinic.org","quote":"A device is implanted deep in your brain that sends electrical pulses episodically (in a series) to disrupt abnormal epileptic brain waves that might happen far away from the DBS electrode.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A3","text":"You have not yet tried anti-seizure medications","name":"Anti-seizure medications","source":{"url":"https://my.clevelandclinic.org/services/epilepsy-seizures-treatment","host":"my.clevelandclinic.org","quote":"Your provider may first try anti-seizure medications to stop your seizures.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"anterior-temporal-lobectomy","name":"Anterior temporal lobectomy with amygdalohippocampectomy","how_it_works":{"text":"The procedure removes seizure-causing temporal lobe tissue","source":{"url":"https://my.clevelandclinic.org/health/diseases/17778-temporal-lobe-seizures","host":"my.clevelandclinic.org","quote":"A temporal lobectomy (removal of part of your temporal lobe) is the most common type of surgery.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":4,"max":6,"unit":"weeks","label":"4–6 weeks","source":{"url":"https://my.clevelandclinic.org/health/treatments/5015-epilepsy-surgery","host":"my.clevelandclinic.org","quote":"You’ll need plenty of rest as you slowly return to your normal daily activities, in about four to six weeks.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}},{"id":"lesionectomy","name":"Lesionectomy or focal cortical resection","how_it_works":{"text":"The procedure removes seizure-starting or abnormal brain tissue","source":{"url":"https://my.clevelandclinic.org/health/treatments/5015-epilepsy-surgery","host":"my.clevelandclinic.org","quote":"Removing the part of your brain where the seizures start or removing the abnormal brain tissue that’s causing the seizures.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":4,"max":6,"unit":"weeks","label":"4–6 weeks","source":{"url":"https://my.clevelandclinic.org/health/treatments/5015-epilepsy-surgery","host":"my.clevelandclinic.org","quote":"You’ll need plenty of rest as you slowly return to your normal daily activities, in about four to six weeks.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}},{"id":"laser-interstitial-thermal","name":"Laser interstitial thermal therapy (LITT)","how_it_works":{"text":"Lasers target and eliminate the brain area where seizures begin","source":{"url":"https://my.clevelandclinic.org/services/epilepsy-seizures-treatment","host":"my.clevelandclinic.org","quote":"During this minimally invasive surgery, lasers are used to pinpoint the exact area of the brain where the seizures are happening and eliminate the focus (where the seizures begin).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":2,"max":2,"unit":"weeks","label":"2 weeks","source":{"url":"https://healthcare.utah.edu/neurosciences/neurosurgery/laser-ablation","host":"healthcare.utah.edu","quote":"It takes about two weeks to recover fully and resume normal activity at home after leaving the 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