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Epilepsy and Seizures: Overview

Epilepsy and Seizures: Overview

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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$Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note$

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Posterior quadrant disconnection for refractory epilepsy: how I do it.

Sami Barrit^1,2, Eun-Hyoung Park^2,3, Joseph R Madsen^4,5

¹Service de Neurochirurgie, Hôpital Erasme, Université Libre de Bruxelles, Anderlecht, Belgium.

Acta Neurochirurgica

|May 16, 2022

Summary

Posterior quadrant disconnection (PQD) offers a less invasive surgical option for intractable epilepsy. This case study details a total PQD procedure for a patient with Sturge-Weber syndrome, highlighting surgical steps and management insights.

Keywords:

Disconnection Epilepsy surgery Posterior quadrant

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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

Published on: August 15, 2025

Area of Science:

Neurosurgery
Epileptology
Pediatric Neurology

Background:

Posterior quadrant disconnection (PQD) is a surgical technique aimed at controlling intractable unilateral temporo-parieto-occipital epilepsy.
Selected cases of posterior multilobar epilepsy may benefit from PQD as a less invasive alternative to hemispherotomy or hemispherectomy.

Observation:

This report details an enhanced operative video of a total PQD in a 15-year-old boy with Sturge-Weber syndrome experiencing recurrent seizures post-partial PQD.
The surgical procedure involved three key steps: parieto-occipital disconnection, posterior callosotomy, and temporal disconnection/resection, with emphasis on anatomical landmarks and multimodal intraoperative guidance.

Findings:

The case illustrates the application and technical considerations of total PQD for complex epilepsy syndromes.
Discussion includes critical pearls and potential pitfalls encountered during the surgical management of such cases.

Implications:

PQD represents a viable, less invasive surgical strategy for specific pediatric epilepsy cases, potentially offering better outcomes than more extensive resections.
This detailed case presentation serves as a valuable educational resource for neurosurgeons managing challenging epilepsy cases.