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Surgical Treatment of Epilepsy

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Emergency Approaches to Neurosurgical Conditions

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Abstract

Epilepsy is common disorder defined as recurrent, unprovoked seizures, with many etiologies including genetic and acquired conditions. It causes not only seizures but also deficits in patients’ cognition, mood and socioeconomic status. Treatment of epilepsy includes anti-epileptic medications as well as numerous surgical interventions. Before undertaking any surgical intervention, one must fail maximal medical therapy, after which they undergo a battery of diagnostic tests to guide surgical planning. These diagnostic tests include functional tests such as electroencephalography (both non-invasive surface EEG and invasive subdural or depth electrodes), functional MRI, the Wada test, and neuropsychological testing and MRI. There are many options for surgical intervention including neuroablation, neuromodulation and resection. Neuroablation can be performed via radiofrequency thermocoagulation, magnetic resonance-guided focused ultrasound surgery, laser ablation and stereotactic radiosurgery. Neuromodulation includes vagal nerve stimulation (VNS) and deep brain stimulation (DBS). Epilepsy surgery includes temporal lobectomy, hemispherectomy, and corpus callosotomy. Outcomes after surgery have been modest, and they continue to improve. Below we describe in further detail the background of epilepsy patients as well as the diagnostic and treatment modalities.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Methodist Neurological Institute, 6560 Fannin St, Suite 944, Houston, TX, 77030, USA

    Todd S. Trask MD

  2. Department of Neurosurgery, Houston Methodist Hospital, 6565 Fannin, Houston, TX, 77030, USA

    Videndra Desai MD

Authors
  1. Todd S. Trask MD
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  2. Videndra Desai MD
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Corresponding author

Correspondence to Todd S. Trask MD .

Editor information

Editors and Affiliations

  1. Neurosurgery/Radiology, Brigham and Women's Medical Hospita Harvard Medical School, Boston, Massachusetts, USA

    Abhishek Agrawal

  2. Department of Neurosurgery, Methodist Neurological Institute, Houston, Texas, USA

    Gavin Britz

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© 2015 Springer International Publishing Switzerland

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Trask, T.S., Desai, V. (2015). Surgical Treatment of Epilepsy. In: Agrawal, A., Britz, G. (eds) Emergency Approaches to Neurosurgical Conditions. Springer, Cham. https://doi.org/10.1007/978-3-319-10693-9_18

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  • DOI: https://doi.org/10.1007/978-3-319-10693-9_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-10692-2

  • Online ISBN: 978-3-319-10693-9

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