Advances in epilepsy surgery

Abstract EN

The history of epilepsy is probably as long as human race.

It is estimated that 6-7% ofpopulation suffer at least °ne seizure at some time in their life, between 0.5-1% ٠/ population sufferfrom active epilepsy.

Drug treatment even when successfulis only suppressive, since none of the drugs ،١ curative.

Surgical approach, hence is more logical «١ it Would eliminate the cause ofthe seizures.

In pediatric age group, the needfor early surgery is even greater asfrequent Seizure activity interferes with neuronal migration, leading to mental retardation.

For several years 0/d}’ small number ofpatients were 0ffered surgery, however, advances ،ft neuroimaging studies and development ofnew surgical techniques have enabled to deal with the lesion in the eloquent areas, without .

majorproblem.

Aim of Surgery Surgical aim is to excise the discrete zone of epileptogenic tissue, to decrease the mass of abnormal tissue where complete excision is not possible or to perform the disconnection procedures ة'،ء؛'اظآا؛ with the spread آه the seizure Preoperative Assessment In order to localize the tissue which is structurally and functionally abnormal, both anatomical evidences and functional findings are re؟uired.

Before the advent of MR؛, temporal lobe oriented images of آء were used to indicate abnormalities like mesial temporal Sclerosis؛ AVM, and areas of calcification.

MRI is widely available now a days and its multiplanner Paging capabilities, high sensitivity for small and low grade tumors has made it investigation of choice for anatomical localization of focus.

MR volumetric studies and MR spectres-