Tactical Considerations Leading to Surgical Treatment of the Partial Epilepsies

  • Paul H. Crandall
  • William Sutherling


The goal of surgical treatment of the epilepsies is to achieve safety and efficacy, much as has been done with antiepileptic medical treatment since about 1969 (3). The partial epilepsies are of cerebral cortical origin and the safety of the operation depends on the cortical locale, the relationship to important vessels and the avoidance of damage to long subcortical fasciculi. The efficacy of the operations depends on the accuracy of the diagnosis. Of the two considerations the latter seems to be the more important, for surgical operations for epilepsy are largely a onetime opportunity. Second operations seldom can be expected to be successful. If it is the temporal lobe, the opposite cannot be removed. If another lobe is responsible, the cost in additional cognitive loss of a second operation is usually too great. In our opinion the electrophysiological verification of epileptogenesis in each patient prior to surgery is essential for successful surgery, especially in the cases which it is difficult to localize the epileptic focus.


Temporal Lobe Temporal Lobe Epilepsy Hippocampal Formation Partial Epilepsy Complex Partial Seizure 
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Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Paul H. Crandall
    • 1
  • William Sutherling
    • 1
  1. 1.Division of Neurosurgery and Department of NeurologyUCLA Medical CenterLos AngelesUSA

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