Advances In Surgical Treatment of Epilepsy

Abstract

Surgery is being used increasingly as a treatment for medically refractory epilepsies. Careful patient selection is essential for successful surgery. With the advent of video/EEG monitoringi advances in structural and functional neuroimaging such as magnetic resonans (MR) imaging. positron emission tomography (PET), and single photon emission computed tomography (SPECT), and technical advances with invasire electrode placement, epilepsy surgery is becoming safer and more effective. Temporal lobectomy is the most frequently performed and effective surgical procedure. Corpus calosotomy is a palliative surgery to reduce the number and severity of atonic, tonic and tonic-clonic seizures. Functional hemispherectomy is beneficial for patients with seizures arising from a hemisphere where there is severe contralateral motor, somatosensory, and visual impairment. New procedures, such as partial hemispherectomy and multipl subpial transections appear promising, but will require additional study.