Surgical treatment of the extratemporal epilepsies.

Full Abstract

Epilepsy that originates outside of the temporal lobe can present some of the most challenging problems for surgical therapy. These epilepsies can be broadly categorized as lesional or non-lesional, with the nonlesional cases being the most difficult to localize. Lesional cases can result from malformations of cortical development, tumors, vascular malformations, or areas of old injury. Some lesions, such as focal cortical dysplasia, can be challenging, in that the boundaries of the pathology can be difficult to define. Presurgical goals include defining the structural lesion, the physiologic abnormality, and normal function in the area. These goals can be achieved using a variety of noninvasive and invasive tests. Surgical techniques vary depending on location and pathology but they always include removal of the epileptic brain tissue while preserving en passage vessels and underlying white matter tracts. Surgical outcomes vary depending on the underlying pathology. Surgeries are usually planned with a goal of no expected postoperative deficits, although temporary deficits may be anticipated in some areas, such as the supplementary motor cortex. Extratemporal epilepsy can be managed well with surgical treatment; but proper patient selection, evaluation, and discussion of expected outcomes and risks are critical in this challenging patient population.

Author information

Author/s: Roper, Steven N (SN);

Affiliation: Department of Neurosurgery and the McKnight Brain Institute, University of Florida, Gainesville, Florida, USA. roper(-atsign-)neurosurgery.ufl.edu

Journal and publication information

Publication Type: Case Reports; Journal Article; Review

Journal: Epilepsia (Epilepsia), published in United States. (Language: eng)

Reference: 2009-Sep; vol 50 Suppl 8 (issue ) : pp 69-74

Dates: Created 2009/08/25; Completed 2009/09/11;

PMID: 19702737, status: MEDLINE (last retrieval date: 9/11/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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