[Report on the surgery for epilepsy].
OBJECTIVE
We review the clinical indications and outcomes of surgical procedures in epilepsy which is resistant to medical treatment and the current situation and future possibilities of carrying out surgery for epilepsy in Spain.


METHODS
Search of the scientific literature included in the data base MEDLINE for the period 1995-1997, retrieval of reports in relation to agencies for the evaluation of health technology of the INAHTA network and the data base of the Cochrane library. The surgery of epilepsy reduces the frequency of seizures (the basic result analyzed) in all groups of patients, although in a very variable manner, depending on the clinical situation and type of operation. The results in patients with temporal lobe epilepsy and in those with localized lesions are particularly good (temporal lobe epilepsy and lesionectomy) (67-69% without seizures), with a follow up period of one to two years. It is estimated that in Spain between 75 and 300 new cases per year would benefit from surgery. The number of patients with drug-resistant epilepsy operated on in Spain is approximately 100-150 patients per year.


CONCLUSIONS
Operations for epileptic syndromes, where there are surgically resectable lesions, should be justified by the gravity and impact of the disease on the psychosocial and functional development of the patient. Insufficiency resources are dedicated to the option of surgical treatment and perhaps they are also underused. These operations should be carried out in highly specialized centres, with adequate resources and an annual volume which guarantees excellence.
González-Enríquez
J
J
Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, España. jgonza@isciii.es
García-Comas
L
L
Conde-Olasagasti
J L
JL
D001921:Brain / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005069:Evaluation Studies as Topic; D006298:Health Services Administration; D006801:Humans; D019635:Neurosurgical Procedures / Q000592:standards*; D013030:Spain
Informe sobre la cirugía de la epilepsia.