Epilepsy Surgery in 2019 : A Time to Change

Area of Science:

• Neurology
• Neurosurgery
• Epileptology

Background:

• Epilepsy has a long history, with surgical treatments evolving significantly over time.
• Recent years have seen major shifts in epilepsy classification, drug discovery, and understanding of the condition.
• The traditional view of focal epilepsy is being replaced by a network disorder paradigm.

Purpose of the Study:

• To highlight the significant changes and advancements in epilepsy diagnosis and treatment.
• To discuss the implications of the revised epilepsy classification system.
• To explore novel therapeutic approaches in epilepsy management.

Main Methods:

• Review of recent updates in epilepsy classification systems.
• Analysis of emerging trends in antiseizure drug discovery, particularly genetic targets.
• Evaluation of the growing role of stereotactic electroencephalography (SEEG) in network disorder assessment.
• Discussion of minimally invasive ablative and neuromodulatory therapies.

Main Results:

• A revised classification system for seizure and epilepsy types was introduced in 2017.
• Novel antiseizure drugs targeting genetic changes show significant therapeutic potential.
• Epilepsy is increasingly viewed as a network disorder, moving away from focal concepts.
• Stereotactic electroencephalography (SEEG) is gaining prominence for evaluating neuronal network dysfunction.
• Minimally invasive therapies and neuromodulation are key in managing dysfunctional epilepsy networks.

Conclusions:

• The field of epilepsy management is undergoing rapid transformation.
• Clinicians must adapt to new terminology and conceptual frameworks.
• Advanced neuroimaging and therapeutic interventions are crucial for addressing complex epilepsy cases.
• Targeted therapies and network-based approaches represent the future of epilepsy treatment.