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The Current Place of Epilepsy Surgery

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Surgical Treatment of Epilepsies

Abstract

Over the last decades, surgical options for the treatment of pharmacoresistant epilepsies have found increasing acceptance. According to a review of the US National Association of Epilepsy Centers, the number of surgical centers for epilepsy rose from 37 to 189 between 2003 and 2012. Comparing epilepsy surgical care in Europe before and after 2000, it has been concluded that the number of specialists involved in epilepsy surgery had increased, and that the gap between the least and the best provided areas had diminished. The current status of epilepsy surgery may be summarized by the following statements: (1) epilepsy surgery is still underused, particularly in the pediatric age, (2) epilepsy surgery is considered too late, (3) resective surgery decreases in adults and in temporal location, (4) there is a shift to pediatric epilepsy surgery and more complex extratemporal resections, and (5) there are promising developments in the epilepsy surgical program with respect to diagnostics, surgical treatment, and postoperative care. Overall, there is general consensus that all epilepsy patients who fail to gain seizure control with two appropriate AED schedules should get access to a full-service epilepsy center for assessment by a multidisciplinary team of epilepsy specialists, and that the right time for surgical intervention including in the first years of life has to be defined in pediatric epilepsy syndromes, in order to facilitate young children an undisturbed development at sensitive windows of brain maturation. Given the favorable results of epilepsy surgery and its cost-effectiveness, adequate resources should be made available to provide patients the chance to become seizure-free by a surgical intervention, and, particularly, to enable children the start into a life without the burden of epilepsy.

Our knowledge is for today, the truth is for eternity

Ramon Y Cajal

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    Josef Zentner

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Zentner, J. (2020). The Current Place of Epilepsy Surgery. In: Surgical Treatment of Epilepsies. Springer, Cham. https://doi.org/10.1007/978-3-030-48748-5_17

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