[Cutting edge of surgical treatment for epilepsy]

Epilepsy surgery is indicated for drug-resistant epileptic seizures. Resective surgery for mesial temporal lobe epilepsy associated with localized lesions has become an established and recommended treatment that achieves abolishment of disabling seizures in 80% of patients. However, surgical outcome of resective surgery for nonlesional and neocortical epilepsies are not satisfactory. For these patients, various approaches are being promoted including development or modification of surgical procedures represented by disconnective surgery, multiple subpial and hippocampal transection, introduction of better analysis methods of EEG for localization of epileptic foci and functional areas, and neuromodulation treatments including by vagus nerve stimulation, deep brain stimulation and closed-loop electrical stimulation.