In simple words: This surgery is done to treat severe epilepsy that doesn't respond to medication. The surgeon opens the skull, cuts specific nerve fibers in the brain, and uses a recording of brain activity to make sure the right fibers are cut.

This procedure involves creating an opening in the skull (craniotomy) to access the brain. The surgeon elevates a bone flap, then performs multiple subpial transections (cutting nerve fibers in the outer layer of the brain). Electrocorticography (recording brain electrical activity) is used during the surgery to guide the transections.

Example 1: A patient with drug-resistant epilepsy localized to a specific area of the brain undergoes this procedure to interrupt the abnormal electrical activity., A patient with seizures originating from multiple areas of the brain may require multiple subpial transections guided by electrocorticography., A child with severe epilepsy undergoes this surgery to improve seizure control and quality of life when other treatments have failed.

Documentation should include the diagnosis of intractable epilepsy, previous failed treatments, brain imaging results, electrocorticography findings, operative report, and post-operative care.