Epilepsy surgery and vagal nerve stimulation: what all neurologists should know.
Epilepsy surgery treatment should be considered as standard of care for all patients with medically intractable partial-onset epilepsy who are found to be good surgical candidates based on their presurgical evaluation. Delaying surgical treatment continues to be a problem among neurologists. The early recognition of pharmacoresistance and patients' referral for presurgical evaluation can shorten the time to identify potential surgical candidates. A successful early surgery can be expected to significantly improve these patients' quality of life, not only because of a seizure-free state but also by improving psychiatric comorbidities. Vagal nerve stimulation (VNS) is currently the only FDA-approved neurostimulation treatment strategy for patients who are not considered candidates for epilepsy surgery. VNS has been shown to decrease seizure frequency by approximately 50% in 30 to 40% of implanted patients. The future of epilepsy surgery and neurostimulation for those individuals with medically intractable partial-onset epilepsy shows great promise.
Balabanov
Antoaneta
A
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612, USA. Antoanetta_J_Balabanov@rush.edu
Rossi
Marvin A
MA
D004351:Drug Resistance / Q000502:physiology; D042241:Early Diagnosis; D004599:Electric Stimulation Therapy / Q000379:methods / Q000592:standards* / Q000639:trends; D004567:Electrodes, Implanted / Q000592:standards; D004632:Emergency Medical Services / Q000592:standards; D004827:Epilepsy / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D009462:Neurology / Q000592:standards; D019635:Neurosurgical Procedures / Q000379:methods / Q000592:standards* / Q000639:trends; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000502:physiology*