Epilepsy surgery: Difference between revisions
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{{Epilepsy}} | {{Epilepsy}} | ||
{{CMG}} {{AE}} {{VVS}} | {{CMG}} {{AE}} {{VVS}} | ||
== Overview == | |||
== 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== | ||
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* Curative | * Curative | ||
** Lesional resection | ** Lesional resection | ||
** Lobectomy | ** [[Lobectomy]] | ||
** Corticectomy | ** Corticectomy | ||
** Hemispheric disconnection | ** Hemispheric disconnection | ||
** Multiple subpial transactions | ** Multiple subpial transactions | ||
** 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 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 == | ||
Contraindications for vagal nerve stimulation includes: | [[Contraindication|Contraindications]] for [[Vagus nerve stimulation|vagal nerve stimulation]] includes: | ||
* cardiac arrhythmias | * [[Cardiac arrhythmia|cardiac arrhythmias]] | ||
* respiratory diseases such as asthma | * respiratory diseases such as [[asthma]] | ||
* | * [[Hoarseness]] | ||
* 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 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== | ||
Revision as of 17:00, 6 December 2018
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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]
Overview
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
- Hoarseness
- gastric ulcers
- vasovagal syncope
- previous left or bilateral cervical vagotomy
- progressive intracerebral disease [2]
Contraindications for deep brain stimulation includes:
- unstable heart disease
- active infection
- significant subcortical arteriosclerotic encephalopathy
- malignancy with markedly reduced life expectancy
- abnormal findings on presurgical imaging (except for minor atrophy)[3][4]
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.
- ↑ 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.
- ↑ 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.