Surgery of epilepsy: methods

The various surgical methods used in the management of epilepsy are reviewed. Intracranial recording procedures such as epidural and subdural recording are presented as well as their main indications, advantages and inconveniences. Emphasis is placed on the techniques of intracranial recording used at the Montreal Neurological Institute, namely chronic cortical and depth recording, both based on stereotactic localization procedures using MRI and DSA. The various resective procedures for the surgery of epilepsy are discussed, namely cortical resections in various locations such as frontal, central parietal, occipital and temporal areas. Special emphasis is placed on techniques of cortical resection in the dominant hemisphere, using local anaesthesia and topographic mapping. The indications and techniques of such procedures as callosotomy, selective amygdalohippocampectomy, hemispherectomy, and stereotactic interventions are also presented.