What types of epilepsy surgeries are available

What types of epilepsy surgeries are available? 

The most effective method to treat pharmacoresistant focal epilepsy is epilepsy surgery.

Surgical treatment has been divided into

(1) focal resections (e.g., anterior temporal lobe resection),

(2) disconnections or neuroablation procedures (e.g., corpus callosotomy, hemispherotomy, and multiple subpial transections)

(3) neuromodulation (e.g., vagus nerve stimulation and responsive neurostimulation procedures).

Focal resection results in the best seizure control among these procedures.

However, it should be noted that only about half of the pharmacoresistant patients with epilepsy are candidates for epilepsy surgery.

For the remaining patients, palliative procedures, such as disconnection or neuromodulation, may be considered, aiming at reduction in the seizure burden. 

Sources

  • Engel J Jr., Wiebe S, French J, et al.: Temporal lobe and localized neocortical resections for epilepsy. From AAN Guidelines Practice parameter. Neurology 60:538-547, 2003. 
  • Haneef Z, Maheshwari A (eds): A concise manual of epilepsy . Boston, Neurogroups Publications, 2015. 
  • Kwan P, Brodie MJ: Early identification of refractory epilepsy. N Engl J Med 342:314-319, 2000.
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