A rediscovered surgical procedure is providing hope to epileptics who don't benefit from medication.

First pioneered in Montreal in the 1930s by the world-renowned neurosurgeon Dr. Wilder Penfield, "the Montreal Procedure" involves the surgical removal of brain tissue at the location of seizure activity.

Surgeons determine the location by using diagnostic imaging and by probing a patient's brain with electrodes. More than half of Penfield's patients were successfully treated. Now, because of improvements to diagnostic technology and patient screening, doctors say the success rate for curing seizures is as high as 80 per cent.

In Canada, surgical candidates number around 20,000 out of the estimated 300,000 who suffer from epileptic seizures. But doctors say that 98 per cent of those candidates aren't getting the brain surgery.

"Epilepsy surgery is probably one of the most under-utilized operations of our modern time," said Dr. Taufik Valiante, from Toronto's Krembil Neuroscience Centre, who is one of only 15 neurosurgeons who perform the operation in Canada.

"(Patients) are sort of in this middle ground, this wasteland if you want to call it, and they are there because of a lack of knowledge."

Living with Epilepsy

Watching a tape of Tom Stadnisky having an epileptic seizure is disturbing. His body shakes violently as he is wracked with convulsions. He loses consciousness and in the process hurts himself. The spasms last for minutes at a time and come on without any warning.

"My tongue (gets) very, very swollen and I usually bite it several times. I apparently have very violent seizures. Of course I don't remember them but the inside of my mouth is all chewed up and I feel like I could sleep for a couple of days," said Stadnisky, describing his attacks for W-FIVE.

The 36-year-old father of two, from London, Ont., suffered his first epileptic seizure seven years ago. Stadnisky doesn't know why the seizures started or what caused them. He only knows that they've been devastating and brutal.

Epileptic seizures are caused by sudden electrical activity in the brain. Sometimes the seizures are linked to brain injuries or to genetic history, but in most cases, the cause of epilepsy remains a mystery. Seizures range in intensity, from partial seizures where epileptics experience muscular jerks or odd sensations, to the severe convulsions associated with gran mal seizures.

In addition to suffering through the physical effects of their seizures, epileptics often contend with the stigma associated with their condition and face social isolation.

After suffering a number of epileptic seizures Stadnisky was forced to quit driving, gave up his job and spends days alone, at home, while his family is at work and school.

"The one word that could pretty much sum it up is -- I felt like I was inadequate. I was inadequate as a father, inadequate as a husband," said Stadnisky.

He has been taking medication to blunt his epilepsy. The drugs can reduce the severity of his attacks, but have not eliminated his seizures entirely.

"He would still have a couple of seizures (each) month - which, in his case, (were) disturbing," explained his neurosurgeon, Dr. Sandrine deRibaupierre, who works at Ontario's London Health Sciences Centre.

Her solution: to use the little known Canadian procedure to try to cure his illness. For Stadnisky that meant risky surgery to remove the regions of his brain that doctors believed were causing his epileptic attacks.

When the procedure was proposed -- an operation that could leave him paralyzed or sightless or speechless -- Stadnisky felt he had no choice but to undergo the operation.

"(Could) I keep living on way reduced sleep? (Could) we keep living on, you know, not a full pay-cheque? (Could) we keep living on me struggling just to sit here all day with nobody around me?" asked Stadnisky. Clearly, the answer was no.

The Operation

On an early spring day in April, Tom Stadnisky hugged and kissed his kids goodbye and, with wife, Isla, headed for the London Health Sciences Centre. It was the day of his dangerous surgery.

In many operations of this type, MRI scans can help locate the regions of the brain that are causing the problem. In Stadnisky's case it was more complicated.

Once prepped and on the operating table, Dr. deRibaupierre probed Stadnisky's brain with an electrode in an effort to locate the suspect areas and to avoid cutting away critical brain tissue. By observing his reactions, Dr. deRibaupierre could determine which cognitive functions or parts of Stadnisky's body were being controlled by different spots in the brain.

Even more critical, because those regions were close to the brain's language centre, Stadnisky needed to be awake during the operation, to ensure he continued to talk.

Soon after the electrical stimulation began, Dr. deRibaupierre pinpointed the source of Stadnisky's epileptic seizures. "So Tom, I'm going to start cutting your brain," she announced to her patient.

In all, the surgery removed three small pieces of Stadnisky's brain, one about the size of a dime, and the hippocampus, about the size of a little finger.

It seems to have worked. Since the surgery, Stadnisky's seizures have stopped and, with a clean bill of health, he's planning to resume driving and hopes he can go back to work and resume a normal life.

"To see (patients) sort of regain what they have lost or obtain something they may have not expected is a remarkable feeling," said Dr. Valiante. "We don't have that many opportunities in our lives to do that to people."

"I hope it works out, of course. That's why I got the whole thing done," said Stadnisky. "If it didn't, you know what? I tried. And I would try to tell other people they should try for it."

• For more information on whether you or someone you know could be a candidate for this surgery, please contact the Canadian Epilepsy Alliance at 1-866-EPILEPSY.