Before an elective surgery, a patient and doctor must compare the risks and benefits of the operation itself to those of ongoing seizures. While surgery has risks, seizures and high doses of medications have risks as well. Epilepsy surgery is a time and money commitment. Although surgery is usually covered by health insurance, the cost still is high: From $40,000 to over $100,000! Misperceptions and misunderstandings about surgery are common. While it is vital to have an accurate picture of potential complications, it is also important to eradicate unfounded fears. Similarly, it is critical to have realistic expectations. Many patients worry that removing a portion of the brain will change their personalities, or "who they are," but this is very rarely the case. For most people with uncontrolled epilepsy, the area of the brain that causes seizures is not functioning properly anyway. Since it's not doing what it should be doing, removing it is usually safe. Furthermore, the electrical activity arising in the brain's seizure focus often impairs the functioning of other brain areas. The medical team needs to help the patient and their family understand the risks and benefits of the surgical procedure in context with the risks of uncontrolled seizures or high doses of anti-epilepsy medications. For example, for people with severe or frequent seizures, epilepsy may be progressive and debilitating, with memory and mood problems that worsen with time. Plus, very high doses of medications can adversely affect health. Together, seizures and medication side effects can impair quality of life, including the ability to drive, work, and learn. Of course, the worst complication after any epilepsy surgery is death, which occurs in less than one out of 1,000 cases. But remember that uncontrolled epilepsy can also be deadly! Among people whose seizures are severe enough to be surgical candidates, up to nine percent run the risk of dying from sudden unexplained death syndrome, or SUDEP, over a ten year period. What are the benefits of epilepsy surgery? Depending on the particular type of surgery, more than 60 percent of patients can become seizure free, and 90 percent can enjoy a significant reduction in their seizure activity. Many patients report that in addition to experiencing fewer seizuresthey have an improved quality of life due to reduced depression, and reduced medication burden. These general considerations apply to anyone considering epilepsy surgery, but each particular type of surgery has its own risks, benefits, and success rates that vary by the individual case. To learn more about specific surgeries, please watch the next video in this series.