Epilepsy surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
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:
- Curative
- Lesional resection
- Lobectomy
- Corticectomy
- Hemispheric disconnection
- Multiple subpial transactions
- Gamma knife radiosurgery
- Palliative
- hemispheric surgery
- Multiple subpial transections
- Disconnection procedures such as callosotomy
- Stimulation procedures including vagal nerve stimulation and deep brain stimulation.[1]
Contraindications
Contraindications for vagal nerve stimulation includes:
- cardiac arrhythmias
- respiratory diseases such as asthma
- pre-existing hoarseness
- gastric ulcers
- vasovagal syncope
- previous left or bilateral cervical vagotomy
- progressive intracerebral disease [2]
References
- ↑ 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.
- ↑ Boon PA (September 2001). "Vagus nerve stimulation for refractory epilepsy". J Clin Neurophysiol. 18 (5): 393. PMID 11709642.