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Failed epilepsy surgery: is this the end?

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Abstract

Resective epilepsy surgery can lead to sustained seizure control in 70–80% of patients evaluated for epilepsy surgery, indicating that up to 30% of patients still have recurrent seizures after surgery. Definitions of failed epilepsy surgery vary amongst studies. This review focuses on seizure outcome predictors after reoperation, possible mechanisms of failure and best management for this difficult patient population.

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Abbreviations

AED:

Antiepileptic drug

TL:

Temporal lobe

TLE:

Temporal lobe epilepsy

MTLE:

Mesial temporal lobe epilepsy

TSC:

Tuberous sclerosis

IcEEG:

Intracranial EEG

FCD:

Focal cortical dysplasia

IED:

Interictal epileptiform discharges

SEEG:

Stereo EEG

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Acknowledgements

Riëm El Tahry is funded by Cliniques Universitaires Saint Luc, Brussels, Belgium and Irene Wang by the Cleveland Clinic Foundation, Cleveland, Ohio, USA.

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Authors and Affiliations

  1. Department of Neurology, Center for Refractory Epilepsy, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Av. Hippocrate 10, 1200, Brussels, Belgium

    Riëm El Tahry

  2. Department of Pneumology, Sleep Laboratory, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Av Hippocrate 10, 1200, Brussels, Belgium

    Riëm El Tahry

  3. Cleveland Clinic, Epilepsy Center, Cleveland, OH, 44195, USA

    Irene Zhong Wang

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Correspondence to Riëm El Tahry.

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Dr. Riëm El Tahry has a consultancy agreement with UCB. Dr. Irene Wang has no specific disclosures to report. The authors declare to have no conflict of interest.

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El Tahry, R., Wang, I.Z. Failed epilepsy surgery: is this the end?. Acta Neurol Belg 117, 433–440 (2017). https://doi.org/10.1007/s13760-017-0769-8

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