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A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery
Published on: May 20, 2016
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The current place of epilepsy surgery
1Departments of Neurology, Neurobiology and Psychiatry and Biobehavioral Sciences and the Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Current Opinion in Neurology
|December 27, 2017
Summary
Surgical treatment for drug-resistant epilepsy (DRE) is safe and effective but underutilized. Patients with DRE deserve consultation at specialized epilepsy centers for optimal care and treatment options.
Area of Science:
- Neurology
- Neurosurgery
- Epileptology
Background:
- Drug-resistant epilepsy (DRE) affects a significant patient population.
- Surgical interventions are proven safe and effective for DRE.
- Less than 1% of DRE patients are referred for surgical evaluation.
Purpose of the Study:
- Review recent trends in surgical referral for DRE.
- Discuss advances in epilepsy surgery.
- Identify reasons for underutilization of surgical treatment.
Main Methods:
- Review of recent clinical series and studies on DRE surgical referrals.
- Analysis of factors influencing referral patterns.
- Evaluation of advancements in diagnostic imaging and surgical techniques.
Main Results:
- No increase in DRE surgical referrals over two decades.
- Shift in referrals from major epilepsy centers to lower-volume hospitals with poorer outcomes.
- Increased identification of neocortical lesions via high-resolution MRI impacting surgical approaches.
- Persistent misconceptions limiting patient referrals.
Conclusions:
- Epilepsy surgery remains underutilized due to misconceptions.
- Advocate for all DRE patients to receive consultation at comprehensive epilepsy centers.
- Future advances will enhance surgical safety, efficacy, and patient eligibility.
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