In order to survive life’s traumatic experiences, we tend to push them to one side in our quest for survival. My experience of surgery for epilepsy certainly comes into this category. My epilepsy is long-standing and dates back to midadolescence. The seizures have remained largely intractable to medical treatment and it was only with the advent of routine neuroimaging some years later that it became clear that the cause was a pre-frontal lesion of uncertain diagnosis. At the time, it was decided to watch and wait for any signs of growth or change. Within a year, I began to exhibit signs of a right hemiplegia. I would spill drinks, have difficulty with writing and balance and I started to drag my right foot. A second scan revealed little or no change and mainly because of the position of the lesion and the fact that I had adapted to life with seizures, the advice was to leave well alone. To say that it was not easy to learn to live with the knowledge that I had a lump in my head of uncertain diagnosis would be an understatement. For 3 years I lived in almost constant terror and torment. I would look at my son and daughter, ten and seven years of age at the time and wonder if I would live to see them grow up. My main concern was that they should not know what I was going through and to carry on as normally as possible for their sakes. I had always exercised, believing that the obvious wear and tear that I was subjected to during convulsive seizures meant that I had to try and keep as fit as possible. Exercise also helped me to cope and prevented my muscles from wasting during the time when the hemiplegia was at its worst and it was encouraging to note a slow improvement in my co-ordination. I was learning to cope. I was also increasingly involved in my work which I enjoyed and this claimed much of my time. In the Spring of 1994 I suffered a deterioration in my seizures which became increasingly frequent with episodes of partial status. The focal seizure activity affected the right-hand side of my face and eye and after 5 days and sleepless nights, drove me to seek a clinical opinion. I was quite shocked when I was told to go home and rest. Imaging was not suggested, even in the knowledge that I had a lesion in my brain which may have been responsible for this sudden change in seizure presentation. My instinct for self-preservation had always been good and I believe that this saved me from a much worse fate at this time. I felt my former confidence in this clinician melt away and decided immediately to seek a second opinion. Eventually I was admitted to hospital where I had my first MRI scan. The lesion was said to be anterior to the motor strip and superior to the speech area and it was evident that it had bled previously as well, causing the right-sided weakness and more recently causing my current problems. Resection was spoken of but fortunately it was possible to gain reasonable medical control allowing me to continue my various activities. Just 6 weeks later, disaster struck. I would suddenly lose my speech and then regain it at about 90 second intervals. This was most unnerving especially to people on the telephone when my sudden silence would be greeted by ‘hello? hello?’, the line would often then go dead, the caller assuming that they had been cut off. I returned to the hospital where the speech difficulties were thought to be evidence of a further bleed which was confirmed on a second MRI scan. I realized pretty soon that this was it and that the only option would now be to work me up for surgery and provided that it was thought to be viable, I would have to have an operation or risk permanent deficit, in particular a speech loss or hemiplegia. The investigations took a week to complete and included a taxing 3 hour functional MRI scan during which I was required to speak to myself for long periods of time and press a button each time my speech abated. Once all the results were amassed and reflected on, I was told that I could have the operation. The problem was that as the lesion was situated in a socalled eloquent area, it would probably have to be done under a local anaesthetic. In other words, I would be awake for the major part of the surgery, receiving general anaesthesia only while accessing the lesion and afterwards while closing up.