Recent Advances in Epilepsy Surgery

Abstract

The modern practice of epilepsy surgery requires multiple modalities of presurgical investigations such as video-EEG, intracranial EEG, high-resolution imaging, advanced functional imaging, and clinical analysis. A multidisciplinary approach is essential, including close collaboration between neurosurgeons, neurologists, neurophysiologists, neuropsychologists, neuropsychiatrists, and neuroradiologists. Candidates for epilepsy surgery require a history of seizures that are refractory to appropriate medical therapy. A meticulous selection of candidates will lead to a better chance of freedom from seizure. Epilepsy surgery includes a variety of surgical procedures including resective surgery for focal refractory seizure, which offers a significant chance of seizure freedom in temporal and extratemporal lobe epilepsy. Palliative treatment for patients who are not candidates for resective surgery, such as vagal nerve stimulation, deep stimulation, and callosotomy, offers further options. We reviewed and analyzed the recent scientific literature and forthcoming advances that will impact on the future of epilepsy surgery. This chapter on recent advances in epilepsy surgery emphasizes improved methods of assessment, a better understanding of seizures, the development of new surgical techniques, and the outcome of epilepsy surgery.