Why Do Some Patients Have Seizures After Brain Surgery While Others Do Not?

摘要: Publisher Summary This chapter illustrates the principles that guide clinicians in selecting patients for epilepsy surgery and estimating their prognosis; they also exemplify uncertainties surrounding these very issues. Two cases are discussed here. The first patient was a 45-year-old right-handed male who had his seizure at age of 2 months context fever. He started having recurrent seizures as an adolescent. Over years, treated with multiple antiepileptic drug (AEDs) including phenobarbital, phenytoin, lamotrigine, primidone, valproic acid, most recently levetiracetam carbamazepine. vagal nerve stimulation (VNS) placed 1997 resulted decreased intensity seizures, but no change frequency. second is 24-year-old left-handed Caucasian woman whose likely began 3 or 4 nocturnal episodes emesis she not diagnosed until 6 when suffered her convulsive seizure. Carbamazepine initiated continued to have few complex partial per month. These increased frequency during teens 16 switched gabapentin felbamate due weight gain intractability. Seizure improved on occasional breakthrough persisted. She offered either intracranial depth electrode study focal right occipital resection under guidance electrocorticography. Although informed may fail produce complete control, possibly leading subsequent (dominant) temporal resection, decided pursue resection. has been followed over years since surprisingly remained seizure-free prior medical regimen.