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[Surgical treatment for intractable epilepsy].

H Shimizu

    Rinsho Shinkeigaku = Clinical Neurology
    |September 19, 2002
    PubMed
    Summary
    This summary is machine-generated.

    Epilepsy surgery includes resective and disconnective procedures. Temporal lobectomy offers good outcomes for temporal lobe epilepsy, while multiple subpial transection (MST) enables surgery for eloquent cortex areas.

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    Area of Science:

    • Neurosurgery
    • Epileptology
    • Neurology

    Context:

    • Intractable epilepsy in adults often necessitates surgical intervention.
    • Epilepsy surgery encompasses resective (e.g., temporal lobectomy) and disconnective (e.g., multiple subpial transection - MST) techniques.
    • Temporal lobe epilepsy is a prevalent form of adult intractable epilepsy.

    Purpose:

    • To illustrate the preoperative diagnosis and surgical outcomes of temporal lobectomy and MST.
    • To review noninvasive preoperative evaluation methods for localizing seizure foci.
    • To discuss the efficacy and potential sequelae of temporal lobectomy and MST.

    Summary:

    • Noninvasive evaluations accurately localize seizure foci in 70% of temporal lobe epilepsy cases.
    • Temporal lobectomy yields satisfactory results, with 70% seizure-free and over 90% significantly improved, though verbal amnesia is a risk.

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  • Multiple subpial transection (MST) allows surgical treatment of eloquent cortex, achieving significant improvement in 80% of neocortical epilepsy cases, and is applicable to extensive epileptic foci, Rasmussen's encephalitis, and Landau-Kleffner syndrome.

    • Impact:

    • Provides insights into surgical management strategies for different types of epilepsy.
    • Highlights the effectiveness and limitations of specific epilepsy surgical procedures.
    • Informs clinical decision-making regarding preoperative evaluation and surgical selection for intractable epilepsy.