Abstract

Surgical approaches to epilepsy

Author(s): Aabir Chakraborty and James T Rutka

Surgical treatment for epilepsy is the only currently available treatment that provides the patient with the possibility of becoming seizure free and off anticonvulsants. This article describes many of the recent advances in the field of epilepsy surgery that are used by the epilepsy team to render patients seizure free without neurological or cognitive deficit. In particular, this article discusses the role of magnetoencephalography, recent advances in MRI techniques for preoperative brain mapping, invasive electrode recording and neuronavigation for the work-up of patients prior to definitive surgical treatment. We then discuss the outcome following different epilepsy surgical procedures, including vagal-nerve stimulation, multiple subpial resections and corpus callosotomy. Finally, we describe techniques that do not currently have an established role but hold promise in the treatment of epilepsy. These techniques include deep-brain stimulation and additional forms of neural stimulation for the patient with epilepsy.