Surgical management of epilepsy
•
12 likes•4,160 views
This document outlines the surgical management of epilepsy. It discusses indications for epilepsy surgery including intractable seizures, side effects of medication, and quality of life issues. The goals of surgery are to eliminate or decrease seizures and prevent neurological deficits while improving quality of life. Extensive presurgical evaluation includes imaging, EEG, neurological assessments, and sometimes invasive monitoring. Surgery targets the seizure focus and may include resective procedures or disconnections. Radiosurgery and neurostimulation are also discussed as alternative options.
More Related Content
What's hot
What's hot (20)
Similar to Surgical management of epilepsy
Similar to Surgical management of epilepsy (20)
More from Pirah Azadi
More from Pirah Azadi (12)
Recently uploaded
Recently uploaded (20)
Surgical management of epilepsy
- 3. SURGICAL MANAGEMENT OF EPILEPSY BY DR PIRAH KORAI RESIDENT NEUROSURGEON JPMC, KARACHI, PAKISTAN
- 4. OUTLINES Introduction Indications of Surgery Goals of Surgery Pre-Surgical Evaluation Surgical categories Radiosurgery Conclusion
- 5. INDICATIONS FOR EPILEPTIC SURGERY Intractable epilepsy Intolerable side effects of AED Impaired quality of life To avoid Teratogenicity
- 6. GOALS OF SURGERY Eliminate or decrease epileptic seizures Prevent neurologic deficits due to surgery Improve quality of life
- 7. PRESURGICAL EVALUATION Non-invasive workup Clinical assessment Surface electroencephalogram (EEG) Video EEG Neurophysiology assessment Imaging studies
- 9. SURFACE EEG
- 10. VIDEO EEG
- 13. Imaging MRI- with epilepsy protocols MR Spectroscopy Functional MRI Diffusion Tensor Image/ Tactography PET SPECT
- 15. Left mesial temporal sclerosis
- 16. MR SPECTROSCOPY
- 17. FUNCTIONAL MRI
- 20. . Functional Imaging PET Hypometabolism (interictally) SPECT Hypoperfusion (interictally) Hyperperfusion (ictally)
- 21. . SISCOM (SPECT with MRI coregistration) (in a patient with extratemporal epilepsy)
- 22. INVASIVE TESTS Intracranial electrodes Intracerebral electrodes
- 24. Subdural electrodes Plates Deep Brain Electrodes
- 33. MRI frameless stereotactic localization of focal cortical dysplasia at the base of the central sulcus
- 34. Hemispherectomy
- 35. DISCONNECTIONS
- 41. Vagus Nerve Stimulator Anterior Nucleus of Thalamus Stimulator Deep Brain Stimulator NEUROSTIMULTAION
- 46. RADIOSURGERY
Editor's Notes
- . Neuropsychological Testing Formal neuropsychological testing is important to establish a pre-operative baseline, as a predictor of possible cognitive loss with surgery, and as an additional aid for localization. For example, patients with temporal lobe epilepsy tend to have memory deficits. Those with TLE in the language-dominant (usually left) hemisphere have more prominent deficits in verbal memory compared with visual memory. Patients with average or above average memory function prior to temporal lobectomy have a higher risk of memory decline postoperativley, especially following left (dominant) temporal lobectomy.
- . Neuropsychological Testing Formal neuropsychological testing is important to establish a pre-operative baseline, as a predictor of possible cognitive loss with surgery, and as an additional aid for localization. For example, patients with temporal lobe epilepsy tend to have memory deficits. Those with TLE in the language-dominant (usually left) hemisphere have more prominent deficits in verbal memory compared with visual memory. Patients with average or above average memory function prior to temporal lobectomy have a higher risk of memory decline postoperativley, especially following left (dominant) temporal lobectomy.
- . Neuropsychological Testing Formal neuropsychological testing is important to establish a pre-operative baseline, as a predictor of possible cognitive loss with surgery, and as an additional aid for localization. For example, patients with temporal lobe epilepsy tend to have memory deficits. Those with TLE in the language-dominant (usually left) hemisphere have more prominent deficits in verbal memory compared with visual memory. Patients with average or above average memory function prior to temporal lobectomy have a higher risk of memory decline postoperativley, especially following left (dominant) temporal lobectomy.