Pathophysiological mechanisms and results of stereotactic treatment of generalized epilepsy

The paper describes pathophysiological mechanisms and analyzes the results of surgical treatment of severe forms of drug-resistant generalized epilepsy in 150 patients who underwent surgery at the departments of stereotactic and functional neurosurgery in Tbilisi and Bratislava. The epileptic system of all patients was localized stereoelectroencephalographically (SEEG) by recording spontaneous activity or evoked aparoxysms. SEEG examination indicate that pacemakers of epileptic activity are most frequently localized in the mediobasal structures of the temporal lobes. The long-term results of stereotactic treatment of generalized forms of epilepsy show recovery in 50% of patients and marked improvement in 30%. An individually determined strategy of surgical procedures is the main principle of surgical treatment of severe drug-resistant forms of epilepsy. Depending on indications it can include resection of the cortex or lobes of the brain, single or repeated stereotactic destructions of the pacemaker structures of the epileptic system and the pathways of spread of the spasm discharge, as well as therapeutic electrostimulation of the brain inhibitory systems.