Neurol. praxi. 2015;16(2):77-79

Transformations of epilepsy surgery in the 21st century

prof. MUDr. Milan Brázdil, Ph.D.

Centrum pro epilepsie Brno, 1. neurologická klinika LF MU a FN u sv. Anny, Brno

Modern epilepsy surgery is going through significant changes that can ultimately result in the ability to offer help to most pharmacoresistant patients. These changes can be observed not only with respect to improved preoperative diagnosis, but particularly in terms of an expanding spectrum of epilepsy surgery procedures. There is a clear worldwide trend to use modern resection procedures even in more complicated MRI-nonlesional patients who previously would have almost automatically been excluded from surgical treatment. Of essential importance is also the advent of neurostimulation methods, in particular vagus nerve stimulation and, more recently, deep brain stimulation, helping epilepsy surgery to shake off the label of a highly selective matter and allowing, as part of palliative epilepsy surgery, to significantly increase the quality of life even in the majority of previously "lost" patients. The number of patients ineligible for surgical treatment has thus dramatically decreased and referral of a patient with persisting seizures for consultation to a specialized epilepsy surgery centre has, beyond question, become a fully rational and necessary step.

Keywords: pilepsy, epilepsy surgery, intractability, neurostimulation, resection

Published: May 1, 2015  Show citation