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Published on: March 18, 2020
A modern epilepsy surgery treatment algorithm: Incorporating traditional and emerging technologies
1Department of Neurological Surgery, Vanderbilt University Medical Center, 1500 21st Avenue South, 4340 Village at Vanderbilt, Nashville, TN 37212, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1500 21st Avenue South, 4340 Village at Vanderbilt, Nashville, TN 37212, USA; Department of Biomedical Engineering, Vanderbilt University Medical Center, 1500 21st Avenue South, 4340 Village at Vanderbilt, Nashville, TN 37212, USA; The Vanderbilt Epilepsy Center, Vanderbilt University Medical Center, 1500 21st Avenue South, 4340 Village at Vanderbilt, Nashville, TN 37212, USA.
Epilepsy surgery advances offer new options for patients. This review outlines traditional and emerging surgical techniques, including stereotactic electroencephalography (SEEG), laser interstitial thermal therapy (LITT), and neurostimulation, to guide treatment decisions.
Area of Science:
- Neurosurgery
- Neurology
- Medical Technology
Background:
- Recent technological advancements have expanded epilepsy surgery candidacy and improved quality of life.
- Comprehensive epilepsy centers must integrate traditional and novel technologies for optimal patient care.
Purpose of the Study:
- To review current and emerging epilepsy surgical procedures.
- To provide a framework for incorporating diverse technologies into surgical decision-making.
Main Methods:
- Review of traditional and novel epilepsy surgical procedures.
- Presentation of an example treatment algorithm.
- Discussion of minimally invasive techniques like stereotactic electroencephalography (SEEG) and ablative therapies such as laser interstitial thermal therapy (LITT) and stereotactic radiosurgery (SRS).
- Exploration of neurostimulation for various epilepsy syndromes.
Main Results:
- Minimally invasive SEEG is increasingly used, though subdural grids remain valuable.
- Ablative procedures (LITT, SRS) offer alternatives to craniotomy for select cases.
- Neurostimulation provides palliative options for complex epilepsy types.
Conclusions:
- An updated perspective on epilepsy surgery is crucial for guiding clinical decisions.
- Standardized frameworks and data collection are needed for future research and trials.
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