Surgery of the epilepsy, orientation of patients, stages and results
Isnard, J.
La Revue du Praticien 55(3): 287-293
2005
ISSN/ISBN: 0035-2640 PMID: 15858922 Document Number: 588402
The increasing number of the presurgical epilepsy unit, and the standardisation and simplification of presurgical methods have allowed the development of surgical treatment of pharmacoresistant epilepsy. Pharmacoresistance can be diagnosed and surgical treatment proposed after two years of medicinal treatment. High resolution MRI is a deciding technique for epileptic focus localization. A focal lesion or unilateral Ammon's horn sclerosis are very favourable predictiv factor for surgery's success. Patient presenting temporal lobe epilepsy combined with this anomalie can be offered temporal lobectomy straight away with 80% chance of success. In other cases, intracranial electrodes can help to localise the epileptic cortex and enable surgery. Surgical treatment of pharmacoresistant epilepsy should not be reserved to severe forms but considered as soon as surgical favourable predictive factor has been established.