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Foundations of the Diagnosis and Surgical Treatment of Epilepsy.

TitleFoundations of the Diagnosis and Surgical Treatment of Epilepsy.
Publication TypeJournal Article
Year of Publication2020
AuthorsHussain I, Kocharian G, Tosi U, Schwartz TH, Hoffman CE
JournalWorld Neurosurg
Volume139
Pagination750-761
Date Published2020 07
ISSN1878-8769
KeywordsAblation Techniques, Anterior Temporal Lobectomy, Deep Brain Stimulation, Drug Resistant Epilepsy, Electrocorticography, Electroencephalography, Functional Neuroimaging, High-Intensity Focused Ultrasound Ablation, Humans, Implantable Neurostimulators, Laser Therapy, Magnetic Resonance Imaging, Magnetoencephalography, Neurosurgical Procedures, Positron-Emission Tomography, Prosthesis Implantation, Radiosurgery, Split-Brain Procedure, Tomography, Emission-Computed, Single-Photon, Vagus Nerve Stimulation
Abstract

The diagnostic and surgical management of epilepsy has made enormous strides over the past 3 decades, concomitant with advances in technology and electrophysiologic understanding of neuronal connectivity. Distinct zones have been identified within this network that each communicate and play a role in the genesis of seizures. Invasive and noninvasive modalities for defining the epileptogenic lesion or region have been able to more accurately determine which patients are optimal candidates for treatment when their seizures are refractory to conventional conservative management. Ablative, palliative, and disconnecting procedures have been developed as alternatives for traditional open resection techniques, and in recent studies, they have shown excellent seizure control and mitigation of complications. In this review, we discuss the evolution of these advancements in the management of epilepsy and provide an overview of current and future neurosurgical therapeutic modalities.

DOI10.1016/j.wneu.2020.03.033
Alternate JournalWorld Neurosurg
PubMed ID32689696