Chapter

Epilepsy surgery

Simon Shorvon

in Epilepsy

Published on behalf of Oxford University Press

ISBN: 9780199560042
Published online May 2011 | e-ISBN: 9780199607365 | DOI: http://dx.doi.org/10.1093/med/9780199560042.003.0007

Series: Oxford Neurology Library

Epilepsy surgery

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Epilepsy surgery is defined as surgery carried out specifically to control epileptic seizures, and includes lesional surgery in which the primary indication is the control of seizures. It also implies a particular procedural approach to pre-surgical assessment. • The pre-surgical assessment employs a different set of investigations to that used in other lesional surgery. • The commonest operation carried out is the temporal lobectomy and vagus nerve stimulation. • In well-selected patients, the temporal lobectomy will render up to 60% of patients seizure free in the long term. Adverse effects of the operation include risks of hemipareisis, memory disturbance, psychiatric and psychological change, and upper quadrantic visual field loss. • Vagus nerve stimulation results in a 50% reduction in seizure frequency in approximately one-third of patients. Complications include infection, left vocal cord paralysis, cough, hoarseness, and cardiac conduction defects. • Other operations include focal neocortical resections for other overt lesions (‘lesionectomy’), non-lesional focal neocortical resections, hemispherectomy, and other multilobar resections, and functional procedures such as multiple subpial transection and corpus callosectomy. • Various experimental procedures are under evaluation including focal radiation and deep-brain stimulation.

Chapter.  4754 words.  Illustrated.

Subjects: Neurology

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