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SEIZURE
SURGERY
Epilepsy represents the second most common cause of mental
health disability, particularly among young adults, and accounts
for a worldwide burden of illness similar to that of breast
cancer in women and lung cancer in men. In this country, it
has a prevalence of 5-10 per 1000 population.
Seizures in temporal lobe epilepsy occur both as simple partial
seizures with preserved awareness of surroundings (also known
as auras), and as disabling complex partial seizures in which
consciousness is lost. Generalized convulsions also occur
in a significant number of patients.
In the past, many clinicians who care for patients with epilepsy
have been uncertain about the overall benefit and safety of
costly surgical procedures, and have therefore viewed surgery
as a last resort for patients with intractable seizures.  However
recent advances in neuroimaging and surgical techniques have
improved the surgical treatment of epilepsy to such an extent
that it now appears to be a better early option than waiting
years until multiple anti-seizure drug regimens have failed.
This was recently borne out in a landmark study published
in the New England Journal of Medicine in which the results
of a randomized controlled trial of the results of surgery
for temporal lobe epilepsy was reported. More interestingly
the lead authors of the study speculated further about the
epidemiological impact of their results, and determined that
there will likely be an additional 200,00 patients per year
needing seizure surgery.
Meeting this new demand, San Diego Neurosurgery and Spine
Institute offers the full array of surgical techniques required
for the treatment of seizure disorders. We are versed in the
use of cortical surface electrodes for assistance in diagnosis
and further characterization of a seizure disorder. In addition,
we utilize state-of-the-art functional imaging data in tandem
with image-guided neuronavigation for achieving precise resection
of epileptigenic cortex. Sometimes, such resections also warrant
the use of "awake craniotomy" particularly when
eloquent areas of the brain are involved. Finally we have
an experience with the implantation of vagal nerve stimulators
for treatment of non-localized seizure disorders.
Helpful outside articles and information:
NEW
ENGLAND JOURNAL OF MEDICINE: (articles about epilepsy)
EPILEPSY
FOUNDATION (Charitable foundation for the support of people
with epilepsy)
MGH
GUIDE TO EPILEPSY SUPPORT GROUPS
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