Epilepsy surgery: Difference between revisions

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{{Epilepsy}}
{{Epilepsy}}
{{CMG}} {{AE}} {{VVS}}
{{CMG}} {{AE}} {{Fs}}
 
== Overview ==
== Overview ==
[[Surgery]] is not the first-line treatment option for patients with epilepsy. [[Surgery]] is usually reserved for patients who their [[seizure]] continues to happen despite using maximum dosage of [[Anti-epileptic drugs|anti-seizure drugs]].


== Indication ==
== Indication ==
Surgery is not the first-line treatment option for patients with epilepsy. Surgery is usually reserved for patients who their [[seizure]] continues to happen despite using maximum dosage of anti-seizure drugs.<ref name="pmid12528052" />
[[Surgery]] is not the first-line treatment option for patients with epilepsy. [[Surgery]] is usually reserved for patients who their [[seizure]] continues to happen despite using maximum dosage of anti-seizure drugs.<ref name="pmid12528052" />


==Surgery==
==Surgery==
The goal of surgery in epilepsy can be divided into two categories:  
The goal of [[surgery]] in epilepsy can be divided into two categories:  
* Curative
* Curative
** Lesional resection
** Lesional [[resection]]
** [[Lobectomy]]  
** [[Lobectomy]]  
** Corticectomy
** Corticectomy
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** Multiple subpial transactions
** Multiple subpial transactions
** [[Gamma knife|Gamma knife radiosurgery]]
** [[Gamma knife|Gamma knife radiosurgery]]
* Palliative
* [[Palliative]]
** hemispheric surgery
** Hemispheric [[surgery]]
** Multiple subpial transections
** Multiple subpial transections
** Disconnection procedures such as [[callosotomy]]
** Disconnection procedures such as [[callosotomy]]
** Stimulation procedures including [[Vagus nerve stimulation|vagal nerve stimulation]] and [[deep brain stimulation]].<ref name="pmid12528052">{{cite journal |vauthors=McKhann GM, Bourgeois BF, Goodman RR |title=Epilepsy surgery: indications, approaches, and results |journal=Semin Neurol |volume=22 |issue=3 |pages=269–78 |date=September 2002 |pmid=12528052 |doi=10.1055/s-2002-36653 |url=}}</ref>
** Stimulation procedures including [[Vagus nerve stimulation|vagal nerve stimulation]] and [[deep brain stimulation]]<ref name="pmid12528052">{{cite journal |vauthors=McKhann GM, Bourgeois BF, Goodman RR |title=Epilepsy surgery: indications, approaches, and results |journal=Semin Neurol |volume=22 |issue=3 |pages=269–78 |date=September 2002 |pmid=12528052 |doi=10.1055/s-2002-36653 |url=}}</ref>


== Contraindications ==
== Contraindications ==
[[Contraindication|Contraindications]] for [[Vagus nerve stimulation|vagal nerve stimulation]] includes:
[[Contraindication|Contraindications]] for [[Vagus nerve stimulation|vagal nerve stimulation]] includes:
* [[Cardiac arrhythmia|cardiac arrhythmias]]
* [[Cardiac arrhythmia|Cardiac arrhythmias]]
* respiratory diseases such as [[asthma]]
* Respiratory diseases such as [[asthma]]
* [[Hoarseness]]
* [[Hoarseness]]
* [[Peptic ulcer|gastric ulcers]]
* [[Peptic ulcer|Gastric ulcers]]
* [[vasovagal syncope]]
* [[vasovagal syncope]]
* previous left or bilateral cervical [[vagotomy]]  
* Previous left or bilateral cervical [[vagotomy]]  
* progressive intracerebral disease <ref name="pmid11709642">{{cite journal |vauthors=Boon PA |title=Vagus nerve stimulation for refractory epilepsy |journal=J Clin Neurophysiol |volume=18 |issue=5 |pages=393 |date=September 2001 |pmid=11709642 |doi= |url=}}</ref>
* Progressive intracerebral disease <ref name="pmid11709642">{{cite journal |vauthors=Boon PA |title=Vagus nerve stimulation for refractory epilepsy |journal=J Clin Neurophysiol |volume=18 |issue=5 |pages=393 |date=September 2001 |pmid=11709642 |doi= |url=}}</ref>
Contraindications for [[deep brain stimulation]] includes:
Contraindications for [[deep brain stimulation]] includes:
* unstable heart disease
* Unstable [[Heart diseases|heart disease]]
* active infection
* Active [[infection]]
* significant [[subcortical arteriosclerotic encephalopathy]]
* Significant [[subcortical arteriosclerotic encephalopathy]]
* [[malignancy]] with markedly reduced life expectancy
* [[malignancy]] with markedly reduced [[life expectancy]]
* abnormal findings on presurgical imaging (except for minor [[atrophy]])<ref name="pmid12774214">{{cite journal |vauthors=Landi A, Parolin M, Piolti R, Antonini A, Grimaldi M, Crespi M, Iurlaro S, Aliprandi A, Pezzoli G, Ferrarese C, Gaini SM |title=Deep brain stimulation for the treatment of Parkinson's disease: the experience of the Neurosurgical Department in Monza |journal=Neurol. Sci. |volume=24 Suppl 1 |issue= |pages=S43–4 |date=May 2003 |pmid=12774214 |doi=10.1007/s100720300039 |url=}}</ref><ref name="pmid16810718">{{cite journal |vauthors=Lang AE, Houeto JL, Krack P, Kubu C, Lyons KE, Moro E, Ondo W, Pahwa R, Poewe W, Tröster AI, Uitti R, Voon V |title=Deep brain stimulation: preoperative issues |journal=Mov. Disord. |volume=21 Suppl 14 |issue= |pages=S171–96 |date=June 2006 |pmid=16810718 |doi=10.1002/mds.20955 |url=}}</ref>
* Abnormal findings on presurgical imaging (except for minor [[atrophy]])<ref name="pmid12774214">{{cite journal |vauthors=Landi A, Parolin M, Piolti R, Antonini A, Grimaldi M, Crespi M, Iurlaro S, Aliprandi A, Pezzoli G, Ferrarese C, Gaini SM |title=Deep brain stimulation for the treatment of Parkinson's disease: the experience of the Neurosurgical Department in Monza |journal=Neurol. Sci. |volume=24 Suppl 1 |issue= |pages=S43–4 |date=May 2003 |pmid=12774214 |doi=10.1007/s100720300039 |url=}}</ref><ref name="pmid16810718">{{cite journal |vauthors=Lang AE, Houeto JL, Krack P, Kubu C, Lyons KE, Moro E, Ondo W, Pahwa R, Poewe W, Tröster AI, Uitti R, Voon V |title=Deep brain stimulation: preoperative issues |journal=Mov. Disord. |volume=21 Suppl 14 |issue= |pages=S171–96 |date=June 2006 |pmid=16810718 |doi=10.1002/mds.20955 |url=}}</ref>


==References==
==References==
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[[Category:Pediatrics]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Primary care]]

Latest revision as of 21:37, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Surgery is not the first-line treatment option for patients with epilepsy. Surgery is usually reserved for patients who their seizure continues to happen despite using maximum dosage of anti-seizure drugs.

Indication

Surgery is not the first-line treatment option for patients with epilepsy. Surgery is usually reserved for patients who their seizure continues to happen despite using maximum dosage of anti-seizure drugs.[1]

Surgery

The goal of surgery in epilepsy can be divided into two categories:

Contraindications

Contraindications for vagal nerve stimulation includes:

Contraindications for deep brain stimulation includes:

References

  1. 1.0 1.1 McKhann GM, Bourgeois BF, Goodman RR (September 2002). "Epilepsy surgery: indications, approaches, and results". Semin Neurol. 22 (3): 269–78. doi:10.1055/s-2002-36653. PMID 12528052.
  2. Boon PA (September 2001). "Vagus nerve stimulation for refractory epilepsy". J Clin Neurophysiol. 18 (5): 393. PMID 11709642.
  3. Landi A, Parolin M, Piolti R, Antonini A, Grimaldi M, Crespi M, Iurlaro S, Aliprandi A, Pezzoli G, Ferrarese C, Gaini SM (May 2003). "Deep brain stimulation for the treatment of Parkinson's disease: the experience of the Neurosurgical Department in Monza". Neurol. Sci. 24 Suppl 1: S43–4. doi:10.1007/s100720300039. PMID 12774214.
  4. Lang AE, Houeto JL, Krack P, Kubu C, Lyons KE, Moro E, Ondo W, Pahwa R, Poewe W, Tröster AI, Uitti R, Voon V (June 2006). "Deep brain stimulation: preoperative issues". Mov. Disord. 21 Suppl 14: S171–96. doi:10.1002/mds.20955. PMID 16810718.

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