Surgical treatment of epilepsy
Dam, M.
Ugeskrift for Laeger 158(14): 1965-1968
1996
ISSN/ISBN: 0041-5782 PMID: 8650770 Document Number: 468850
Patients with drug resistant frequent partial seizures rarely remit despite intensive drug treatment. On the contrary, seizures provoke neuronal loss with early mental deterioration and increased mortality. An exact localization of a resectable epileptogenic focus can offer a curative treatment. Mesial temporal sclerosis and lesional cortical partial epilepsy may indicate surgical therapy, both offering freedom of seizures in 50-90% of the patients. Non-lesional cortical partial epilepsy is more problematic, as only 30-40% of the patients will be seizure-free. Volumetric MR investigations, T2 relaxation time measurement and magnetic resonance spectroscopy together with other non-invasive methods have reduced the need for invasive investigations. As the best results are often achieved in children with their greater brain plasticity, surgical therapy should also be considered in children below the age of 12. This will prevent development of their role as chronically ill patients with the known accompanying psychological handicaps.