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Related Concept Videos

Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
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Electroconvulsive Therapy01:30

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Related Experiment Video

Updated: Mar 6, 2026

Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
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Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note

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Failed epilepsy surgery: is this the end?

Riëm El Tahry1,2, Irene Zhong Wang3

  • 1Department of Neurology, Center for Refractory Epilepsy, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Av. Hippocrate 10, 1200, Brussels, Belgium. riem.eltahry@uclouvain.be.

Acta Neurologica Belgica
|March 18, 2017
PubMed
Summary

Epilepsy surgery offers seizure control for most, but some still experience seizures. This review examines predictors of success after repeat surgeries and management strategies for persistent epilepsy.

Keywords:
Epilepsy surgeryFailed surgeryPresurgical evaluation

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Area of Science:

  • Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Resective epilepsy surgery achieves sustained seizure control in 70-80% of patients.
  • However, up to 30% of patients experience recurrent seizures post-surgery, highlighting a significant unmet need.
  • Varied definitions of failed epilepsy surgery complicate outcome assessment across studies.

Purpose of the Study:

  • To review predictors of seizure outcomes following reoperation for epilepsy.
  • To explore potential mechanisms contributing to epilepsy surgery failure.
  • To outline optimal management strategies for patients with persistent seizures after initial surgery.

Main Methods:

  • This is a review article focusing on existing literature.
  • The review synthesizes data on reoperation outcomes, failure mechanisms, and management.
  • Key focus is on identifying predictors for seizure control after repeat surgical interventions.

Main Results:

  • Predictors for successful reoperation in epilepsy surgery are identified.
  • Common mechanisms underlying surgical failure are discussed.
  • Evidence-based management approaches for refractory epilepsy post-surgery are presented.

Conclusions:

  • Reoperation offers a viable option for selected patients with recurrent seizures after initial epilepsy surgery.
  • Understanding failure mechanisms can guide surgical planning and patient selection.
  • A multidisciplinary approach is crucial for managing patients with persistent epilepsy.