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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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Updated: Feb 3, 2026

A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery
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Subpial transection surgery for epilepsy.

Balaji Krishnaiah1, Sridharan Ramaratnam, Lakshmi Narasimhan Ranganathan

  • 1Department of Neurology, Penn State Center, 30 Hope Drive, Hershey, Philadephia, USA, PA 17033.

The Cochrane Database of Systematic Reviews
|November 2, 2018
PubMed
Summary

This review found no studies on subpial transection for refractory epilepsy. More research is needed to determine if this surgery is effective for patients with uncontrolled seizures.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Refractory epilepsy affects nearly 30% of patients despite multiple antiepileptic drugs (AEDs).
  • Medically refractory epilepsy is defined as failure to respond to at least two AEDs.
  • Early surgical intervention for epilepsy may improve cognitive and social outcomes in children.

Purpose of the Study:

  • To evaluate the efficacy of subpial transection surgery for focal-onset and generalized tonic-clonic seizures.
  • To assess the impact of this surgical procedure in both pediatric and adult populations with refractory epilepsy.

Main Methods:

  • A comprehensive search of multiple databases including Cochrane Register of Studies, MEDLINE, ClinicalTrials.gov, and ICTRP was conducted on August 7, 2018.
  • Included studies were randomized and quasi-randomized parallel-group trials, regardless of blinding.
  • Data extraction and verification were planned to be performed independently by two review authors.

Main Results:

  • No relevant studies were identified in the systematic search.
  • The current evidence base does not contain any randomized controlled trials evaluating subpial transection for epilepsy.

Conclusions:

  • There is a lack of evidence to support or refute the use of subpial transection for medically refractory epilepsy.
  • High-quality randomized controlled trials are essential to establish the effectiveness and safety of this surgical intervention.
  • Further research is required to guide clinical decision-making for patients with uncontrolled epilepsy.