J Korean Med Assoc.  2003 Apr;46(4):298-306. 10.5124/jkma.2003.46.4.298.

Epilepsy : Surgical Treatment

Affiliations
  • 1Department of Neurosurgery, Samsung Seoul Medical Cecter, Sungkyunkwan University School of Medicine, Korea. schong@smc.samsung.co.kr

Abstract

Interest in epilepsy surgery is getting more and more increased with the development of computer-EEG and neuroimaging technique. There is a definite subgroup of intractable epilepsy patients who can be treated by surgical treatment. Essential procedures for the satisfactory result of epilepsy surgery include strict patient selection, EEG analysis, anatomical/functional imaging for identification of epileptogenic lesions and seizure onset, neuropsychological test, and intracranial recording procedures. Temporal lobe epilepsy with typical hippocampal sclerosis is the best and most popular surgical candidate. Intractable epilepsy with focal discrete benign lesions (tumors, vascular malformations, granulomas, etc.) can also be good surgical candidates. Localization-related epilepsy with cortical dysplasia and other non-visible lesions can be treated by surgery through intracranial recording procedures. Callosotomy and hemispherectomy can be performed in selected patients with intractable generalized seizures. The importance of comprehensive preoperative investigations cannot be overemphasized.

Keyword

Epilepsy surgery; Indication; Neuroimaging; Hippocampal sclerosis; Lesion

MeSH Terms

Electroencephalography
Epilepsies, Partial
Epilepsy*
Epilepsy, Temporal Lobe
Granuloma
Hemispherectomy
Humans
Malformations of Cortical Development
Neuroimaging
Neuropsychological Tests
Patient Selection
Sclerosis
Seizures
Vascular Malformations

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