Surgical approaches to epilepsy.
Medically intractable epilepsy may be treated successfully with surgery in a high proportion of patients following appropriate clinical and diagnostic evaluation. Recent technical advances provide more precise diagnostic methods, especially for localizing the areas of seizure origin in the cerebral cortex. The excision of epileptogenic cortex remains the main surgical treatment for partial forms of epilepsy, while commissurotomies are appropriate for some patients with a secondary, generalized type of epilepsy. Limited experience with a variety of stereotaxic lesions and the modality of cerebellar stimulation has not yet provided definite evidence of efficacy of these techniques. Following surgical excisions, two thirds of the patients are significantly improved and over one third become seizure free, with morbidity-mortality rates of less than 0.5%.
Blume
H W
HW
Department of Surgery, Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts 02215.
Schomer
D L
DL
D002540:Cerebral Cortex / Q000601:surgery; D003337:Corpus Callosum / Q000601:surgery; D004599:Electric Stimulation Therapy; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D011612:Psychosurgery / Q000379:methods; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed