Strategies for surgical treatment of epilepsies in developing countries.
Epilepsy surgery has been proved to be efficacious, safe and cost-effective in developing countries. However, the success of epilepsy surgery depends on selecting suitable candidates based on the available resources and technologies. Some of the challenges to provide appropriate surgical treatment for epilepsy patients in developing countries include providing human and technological resources and developing realistic presurgical protocols. Detection of ideal candidates for epilepsy surgery is possible for well-trained epileptologists with the help of basic investigative technologies, for example, magnetic resonance imaging (MRI) and electroencephalography (EEG). Patients with potentially epileptogenic, well-circumscribed lesions on MRI and patients with mesial temporal lobe epilepsy (MTLE) are reasonable candidates for surgery. Palliative epilepsy surgeries include corpus callosotomy and other disconnections. These operations are feasible in developing countries with a knowledgeable team consisting of an epileptologist, neurosurgeon and technicians and with using MRI and EEG as basic investigative technologies.
Asadi-Pooya
Ali A
AA
Jefferson Comprehensive Epilepsy Center, Neurology Department, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. aliasadipooya@yahoo.com
Sperling
Michael R
MR
D000654:Amobarbital / Q000008:administration & dosage / Q000494:pharmacology; D038481:Anterior Temporal Lobectomy; D001931:Brain Mapping; D003906:Developing Countries; D004569:Electroencephalography / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000601:surgery; D005240:Feasibility Studies; D007839:Functional Laterality / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007269:Injections, Intra-Arterial; D007802:Language; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008511:Medicine / Q000592:standards; D019635:Neurosurgical Procedures / Q000379:methods*; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D013038:Specialization; D013702:Temporal Lobe / Q000601:surgery
D000654:Amobarbital