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Mechanisms of Epileptogenesis pp 255–279Cite as

Tactical Considerations Leading to Surgical Treatment of the Partial Epilepsies

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Abstract

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.

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Authors and Affiliations

  1. Division of Neurosurgery and Department of Neurology, UCLA Medical Center, Los Angeles, CA, 90024, USA

    Paul H. Crandall M.D. & William Sutherling M.D.

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  1. Paul H. Crandall M.D.
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  2. William Sutherling M.D.
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Editors and Affiliations

  1. The Graduate Hospital, Philadelphia, Pennsylvania, USA

    Marc A. Dichter M.D., Ph.D. (Director of the Comprehensive Epilepsy Center, Professor of Neurology) (Director of the Comprehensive Epilepsy Center, Professor of Neurology)

  2. Department of Neurology, University of Pennsylvania, Philadelphia, Philadelphia, USA

    Marc A. Dichter M.D., Ph.D. (Director of the Comprehensive Epilepsy Center, Professor of Neurology) (Director of the Comprehensive Epilepsy Center, Professor of Neurology)

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Crandall, P.H., Sutherling, W. (1988). Tactical Considerations Leading to Surgical Treatment of the Partial Epilepsies. In: Dichter, M.A. (eds) Mechanisms of Epileptogenesis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-5556-4_16

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  • DOI: https://doi.org/10.1007/978-1-4684-5556-4_16

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-5558-8

  • Online ISBN: 978-1-4684-5556-4

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