A 24-year-old woman with intractable seizures: review of surgery for epilepsy.
Epilepsy, a recurrent seizure disorder affecting 1% of the population, can be genetic in origin and thereby affect multiple members in a family, or it can be sporadic. Many sporadic seizures come from a specific "focus" in the cortex. Focal-onset seizures account for 60% of all cases of epilepsy. Among patients with partial seizures, 35% respond poorly to available medication and may benefit from neurosurgical excisional surgery. In cases in which epilepsy is localized through different modes (electroencephalogram, magnetic resonance imaging, etc) to a specific area of the brain where there is an associated lesion, more than half of patients can expect a successful surgical outcome. In patients with consistent seizure-associated behavior but without a lesion, surgical treatment is less successful. Ms H, a young woman with a history of medically intractable partial epilepsy, does not have an anatomical lesion but wants to know if a surgical approach is a good option for her.
Schomer
Donald L
DL
Laboratory of Clinical Neurophysiology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts, Boston, MA 02215, USA. dschomer@bidmc.harvard.edu
Black
Peter M
PM
D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D003657:Decision Making; D003952:Diagnostic Imaging; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000145:classification / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D019635:Neurosurgical Procedures; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation; D055815:Young Adult
D000927:Anticonvulsants