Surgery for epilepsy

摘要: Despite important advances in the treatment of epilepsy over past several decades, many patients remain uncontrolled. Partial complex (psychomotor) seizures are largest problem, with less than two thirds successfully managed despite optimal medication use. In these situations, various surgical procedures may be helpful, depending on type epilepsy, its cerebral location origin, and neurologic status particular patient. Intensive investigation including EEG audiovisual monitoring utilized to evaluate medically refractory epileptic. some instances, specialized recordings from epidural, subdural or intracerebral locations needed try pinpoint onset focal seizure. When this is possible, epileptogenic area resectable, cortical excision provide cure marked reduction 60 90 per cent properly selected minimal morbidity. The most common operation temporal lobectomy; procedure itself undergoing modifications as more learned about usual seizure foci functions tissue. Resections other areas difficult but possible. a single focus not identified used. Results control chronic cerebellar stimulation have been variable. results stereotaxic lesions exception field H Forel, which reports has effective for grand mal seizures. Generalized seizures, particularly infantile hemiplegia frontal lobe well controlled corpus callosotomy. Surgery currently practiced at centers country abroad. There great need such education estimates indicate 100,000 United States time could benefit procedures.