Imaging and Stereotactic Electroencephalography Functional Networks to Guide Epilepsy Surgery
Derek J Doss1, Graham W Johnson1, Dario J Englot2
1Department of Biomedical Engineering, Vanderbilt University, PMB 351631, 2301 Vanderbilt Place, Nashville, TN 37235, USA; Vanderbilt University Institute of Imaging Science (VUIIS), 1161 21st Avenue South, Medical Center North AA-1105, Nashville, TN 37232, USA; Vanderbilt Institute for Surgery and Engineering (VISE), 1161 21st Avenue South, MCN S2323, Nashville, TN 37232, USA.
Neurosurgery Clinics of North America
|November 24, 2023
Summary
Epilepsy surgery offers a cure for drug-resistant epilepsy but is underused. A new network paradigm helps identify and treat seizure networks for better patient outcomes.
Area of Science:
- Neurology
- Neurosurgery
- Epileptology
Background:
- Drug-resistant epilepsy affects many patients, with surgery being an underutilized curative option.
- Inadequate patient referrals and incomplete understanding of seizure origins limit surgical treatment.
- Increasing complexity of epilepsy cases necessitates advanced treatment strategies.
Purpose of the Study:
- To introduce and explain the evolving network paradigm in epilepsy surgery.
- To highlight the potential of the network paradigm in improving patient selection and treatment.
Main Methods:
- Conceptual review of the shift towards a network-based approach in epilepsy surgery.
- Discussion of diagnostic and therapeutic implications of the network paradigm.
Main Results:
- The network paradigm considers the entire seizure network, not just the focus.
- This approach facilitates better identification of the seizure network.
- It aids in selecting appropriate treatments like resection, ablation, or neuromodulation.
Conclusions:
- The network paradigm represents an evolution in epilepsy surgery.
- It offers a more comprehensive approach to treating complex drug-resistant epilepsy.
- This paradigm has the potential to increase the utilization and effectiveness of epilepsy surgery.
