Emerging surgical and radiotherapeutic techniques for treating epilepsy.
OBJECTIVE
Recent advances in epilepsy surgery have developed a resurgence of interest in the use of surgical techniques for the treatment of intractable epilepsy.


RESULTS
More invasive procedures such as hemispherectomy and multiple subpial transection have become more popular. Disconnective techniques such as multiple subpial transection have provided a surgical option for patients whose epileptogenic zone resides in the eloquent cortex. Alternatively, new minimally invasive neurostimulation therapies have been introduced to preserve maximal cerebral tissue. Radiosurgery has been recently utilized in the treatment of epilepsy with preliminary promising results.


CONCLUSIONS
In this analysis, the authors will attempt to review the more recent surgical approaches and their indications for the treatment of medically intractable epilepsy. For patients with the epileptogenic zone in the noneloquent cortex, seizure focus resection remains the most reasonable approach to therapy.
Cohen-Gadol
Aaron A
AA
Department of Neurological Surgery, Yale University School of Medicine, New Haven, CT 06520-8082, USA.
Stoffman
Michael R
MR
Spencer
Dennis D
DD
D002540:Cerebral Cortex / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000379:methods / Q000639:trends; D004827:Epilepsy / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery*; D038421:Hemispherectomy / Q000009:adverse effects / Q000379:methods / Q000639:trends*; D006801:Humans; D020646:Intralaminar Thalamic Nuclei / Q000503:physiopathology; D020531:Subthalamic Nucleus / Q000503:physiopathology; D013788:Thalamus / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology