Skip to main content

Advertisement

Log in

Novel surgical treatments for epilepsy

  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

The surgical treatment of epilepsy is expanding in an exciting and unprecedented way. This review highlights some of the recent advances in neuroimaging that have improved epilepsy surgery. In addition, novel therapies currently being evaluated in clinical trials, including gamma knife radiosurgery, deep brain stimulation, and responsive stimulation, are discussed. Further surgical developments that will be ready for human application in the near future are highlighted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Colombo N, Tassi L, Galli C, et al.: Focal cortical dysplasias: MR imaging, histopathologic, and clinical correlations in surgically treated patients with epilepsy. Am J Neuroradiol 2003, 24:724–733.

    PubMed  Google Scholar 

  2. Chan S, Chin SS, Nordli DR, et al.: Prospective magnetic resonance imaging identification of focal cortical dysplasia, including the non-balloon cell subtype. Ann Neurol 1998, 44:749–757.

    Article  PubMed  CAS  Google Scholar 

  3. Antel SB, Collins DL, Bernasconi N, et al.: Automated detection of focal cortical dysplasia lesions using computational models of their MRI characteristics and texture analysis. Neuroimage 2003, 19:1748–1759.

    Article  PubMed  Google Scholar 

  4. Montenegro MA, Li LM, Guerreiro MM, et al.: Focal cortical dysplasia: improving diagnosis and localization with magnetic resonance imaging multiplanar and curvilinear reconstruction. J Neuroimaging 2002, 12:224–230.

    Article  PubMed  Google Scholar 

  5. O’Brien TJ, So EL, Mullan BP, et al.: Subtraction peri-ictal SPECT is predictive of extratemporal epilepsy surgery outcome. Neurology 2000, 55:1668–1677.

    PubMed  CAS  Google Scholar 

  6. O’Brien TJ, So EL, Mullan BP, et al.: Subtraction SPECT co-registered to MRI improves postictal SPECT localization of seizure foci. Neurology 1999, 52:137–146.

    PubMed  CAS  Google Scholar 

  7. Sutherland GR, Kaibara T, Louw DF: Intraoperative MR at 1.5 Tesla--experience and future directions. Acta Neurochir Suppl 2003, 85:21–28.

    PubMed  CAS  Google Scholar 

  8. Kaibara T, Myles ST, Lee MA, Sutherland GR: Optimizing epilepsy surgery with intraoperative MR imaging. Epilepsia 2002, 43:425–429.

    Article  PubMed  Google Scholar 

  9. Kida Y, Kobayashi T, Tanaka T, et al.: Seizure control after radiosurgery on cerebral arteriovenous malformations. J Clin Neurosci 2000, 7(suppl 1):6–9.

    Article  PubMed  Google Scholar 

  10. Kurita H, Kawamoto S, Suzuki I, et al.: Control of epilepsy associated with cerebral arteriovenous malformations after radiosurgery. J Neurol Neurosurg Psychiatry 1998, 65:648–655.

    PubMed  CAS  Google Scholar 

  11. Ghossoub M, Nataf F, Merienne L, et al.: Characteristics of epileptic seizures associated with cerebral arteriovenous malformations. Neurochirurgie 2001, 47(pt 2):168–176.

    PubMed  CAS  Google Scholar 

  12. Heikkinen ER, Konnov B, Melnikov L, et al.: Relief of epilepsy by radiosurgery of cerebral arteriovenous malformations. Stereotact Funct Neurosurg 1989, 53:157–166.

    Article  PubMed  CAS  Google Scholar 

  13. Regis J, Bartolomei F, Kida Y, et al.: Radiosurgery for epilepsy associated with cavernous malformation: retrospective study in 49 patients. Neurosurgery 2000, 47:1091–1097. The largest reported series of radiosurgery treatment of cavernous malformation-associated epilepsy is detailed.

    Article  PubMed  CAS  Google Scholar 

  14. Berkovic SF, Arzimanoglou A, Kuzniecky R, et al.: Hypothalamic hamartoma and seizures: a treatable epileptic encephalopathy. Epilepsia 2003, 44:969–973.

    Article  PubMed  Google Scholar 

  15. Rosenfeld JV, Harvey AS, Wrennall J, et al.: Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy. Neurosurgery 2001, 48:108–118.

    Article  PubMed  CAS  Google Scholar 

  16. Palmini A, Chandler C, Andermann F, et al.: Resection of the lesion in patients with hypothalamic hamartomas and catastrophic epilepsy. Neurology 2002, 58:1338–1347.

    PubMed  CAS  Google Scholar 

  17. Nguyen D, Singh S, Zaatreh M, et al.: Hypothalamic hamartomas: seven cases and review of the literature. Epilepsy Behav 2003, 4:246–258.

    Article  PubMed  Google Scholar 

  18. Regis J, Bartolomei F, de Toffol B, et al.: Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Neurosurgery 2000, 47:1343–1351; discussion 1351–1352.

    Article  PubMed  CAS  Google Scholar 

  19. Kurita H, Suzuki I, Shin M, et al.: Successful radiosurgical treatment of lesional epilepsy of mesial temporal origin. Min Invasive Neurosurg 2001, 44:43–46.

    Article  CAS  Google Scholar 

  20. Chen ZF, Kamiryo T, Henson SL, et al.: Anticonvulsant effects of gamma surgery in a model of chronic spontaneous limbic epilepsy in rats. J Neurosurg 2001, 94:270–280.

    PubMed  CAS  Google Scholar 

  21. Regis J, Bartolomei F, Rey M, et al.: Gamma knife surgery for mesial temporal lobe epilepsy. J Neurosurg 2000, 93(suppl 3):141–146.

    PubMed  Google Scholar 

  22. Maesawa S, Kondziolka D, Dixon CE, et al.: Subnecrotic stereotactic radiosurgery controlling epilepsy produced by kainic acid injection in rats. J Neurosurg 2000, 93:1033–1040.

    Article  PubMed  CAS  Google Scholar 

  23. Hodaie M, Wennberg RA, Dostrovsky JO, Lozano AM: Chronic anterior thalamus stimulation for intractable epilepsy. Epilepsia 2002, 43:603–608. This case series details the first five reported patients implanted with anterior nucleus bilateral DBS systems for the treatment of medically intractable epilepsy. In this series, stimulation benefits remained after the devices were turned off.

    Article  PubMed  Google Scholar 

  24. Kerrigan JF, Litt B, Fisher RS, et al.: Electrical stimulation of the anterior nucleus of the thalamus for the treatment of intractable epilepsy. Epilepsia 2004, 45:346–354. This case series details another five patients implanted with anterior nucleus bilateral DBS systems for the treatment of medically intractable epilepsy.

    Article  PubMed  Google Scholar 

  25. Vonck K, Boon P, Achten E, et al.: Long-term amygdalohippocampal stimulation for refractory temporal lobe epilepsy. Ann Neurol 2002, 52:556–565.

    Article  PubMed  Google Scholar 

  26. Chabardes S, Kahane P, Minotti L, et al.: Deep brain stimulation in epilepsy with particular reference to the subthalamic nucleus. Epileptic Disord 2002, 4(suppl 3):S83-S93.

    PubMed  Google Scholar 

  27. Penfield W, Jasper H: Epilepsy and The Functional Anatomy of the Human Brain. Boston: Little Brown; 1954.

    Google Scholar 

  28. Peters TE, Bhavaraju NC, Frei MG, Osorio I: Network system for automated seizure detection and contingent delivery of therapy. J Clin Neurophysiol 2001, 18:545–549. More than 900 closed loop stimulations were delivered to eight patients via an integrated bedside system for seizure detection and responsive stimulation.

    Article  PubMed  CAS  Google Scholar 

  29. Litt B, Lehnertz K: Seizure prediction and the preseizure period. Curr Opin Neurol 2002, 15:173–177.

    Article  PubMed  Google Scholar 

  30. Litt B, Echauz J: Prediction of epileptic seizures. Lancet Neurol 2002, 1:22–30.

    Article  PubMed  Google Scholar 

  31. Litt B, Esteller R, Echauz J, et al.: Epileptic seizures may begin hours in advance of clinical onset: a report of five patients. Neuron 2001, 30:1–3. Five patients are detailed who underwent intracranial EEG recordings during the evaluation of temporal lobe epilepsy. EEG evidence of impending seizures was detectable from minutes to hours before clinical events.

    Article  Google Scholar 

  32. Andrzejak RG, Widman G, Lehnertz K, et al.: The epileptic process as nonlinear deterministic dynamics in a stochastic environment: an evaluation on mesial temporal lobe epilepsy. Epilepsy Res 2001, 44:129–140.

    Article  PubMed  CAS  Google Scholar 

  33. Worrell GA, Parish L, Cranstoun SD, et al.: High-frequency oscillations and seizure generation in neocortical epilepsy. Brain 2004, In press.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

McKhann, G.M. Novel surgical treatments for epilepsy. Curr Neurol Neurosci Rep 4, 335–339 (2004). https://doi.org/10.1007/s11910-004-0061-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11910-004-0061-1

Keywords

Navigation