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Modern Problems in the Surgical Treatment of Epilepsy

Received: 16 February 2021     Accepted: 1 March 2021     Published: 9 March 2021
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Abstract

Background: The surgical treatment of epilepsy is widely recognised by neurosurgeons as the most effective method for treating patients with drug-resistant forms of the disease. Objective: To analyse the results of surgical treatments in patients with epileptic seizures, depending on the applied methods of surgery. Methods: A comprehensive clinical examination of the surgical treatments of 112 patients with various forms of drug-resistant epilepsy was carried out. Results: Hemispherectomy was performed in three patients with positive outcomes. Hippocampectomy was performed for four patients. In two patients, the seizures became medically controlled. In the other two cases, the intervals between seizures were longer and seizures tended to occur at night. Extratemporal resection of the epileptogenic focus was performed in 86 patients, 72% percent of whom became seizure-free. Six patients underwent callosotomy, five of whom were then seizure free. One patient’s seizures resumed after 8 months, this case was also drug-resistant. Thirty two patients underwent multiple subpial transection and were followed-up for approximately 5 years. Excellent results were obtained in 20 (62.5%) patients with seizures ceasing. Conclusions: The results of the study showed sufficient efficiency of the applied methods of surgical treatment for various forms of epilepsy.

Published in Clinical Neurology and Neuroscience (Volume 5, Issue 1)
DOI 10.11648/j.cnn.20210501.12
Page(s) 5-9
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Drug-resistant Forms of Epilepsy, Epileptogenic Zone, Surgical Treatment of Epilepsy

References
[1] Guzeva VI (2007) Epilepsy and non-epileptic paroxysmal states in children. St. Petersburg: Medical Information Agency.
[2] Penfield W, Jasper H (1954) Epilepsy and the functional anatomy of the human brain. Boston: Little, Brown & Co.
[3] Ojemann G (1988) Surgical treatment of epilepsy. Journal of Child Neurology 3: 154-154.
[4] Bien CG, Schulze-Binhage A, Soeder BM (2006) Assessment of long-term effects of epilepsy surgery with three different reference groups. Epilepsia 11: 1865-1869.
[5] Blount JP (2017) Extratemporal resections in pediatric epilepsy surgery - an overview. Epilepsia 58 (Suppl. 1): 19-27.
[6] Alonso Vanegas MA, Lew SM, Morino M, Sarmento SA (2017) Microsurgical techniques in temporal lobe epilepsy. Epilepsia 58 (Suppl. 1): 10-18.
[7] Mukhin K, Petrukhin AS (2000) Idiopathic forms of epilepsy: systematics, diagnosis, therapy. Мoscow. Art-Business-Centre.
[8] Odinak MM, Dyskin DE. Epilepsy (1997) Etiopathogenesis. Clinic. Differential diagnostics. Drug treatment. St. Petersburg: Politekhnika.
[9] Van Wagenen WP, Herren RY (1940) Surgical division of the commissural pathways in the corpus callosum: relation to spread of an epileptic attack. Archives of Neurology and Psychiatry 44: 740-759.
[10] Bogen JE, Vogel PJ (1962) Cerebral commissurotomy in man: preliminary case report. Bulletin of the Los Angeles Neurological Society 27: 169-172.
[11] Morrell F, Whisler WW, Bleck TP (1989) Multiple subpial transection: a new approach to the surgical treatment of focal epilepsy. Journal of Neurosurgery 70: 231-239.
[12] Engel J Jr, Wiebe S, French J, Sperling MR, Williamson PD, Spencer DD et al. (2003) Practice parameters: temporal lobe and localized neocortical resections for epilepsy –Report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons. Neurology 60: 538-547.
[13] Jobst BC, Cascino GD (2015) Resective epilepsy surgery for drug resistant epilepsy. JAMA 313: 285-293.
[14] Mathon B, Navarro V, Bielle F, Nguyen-Michel VH, Carpentier A, Baulac M et al. (2017) Complications after surgery for mesial temporal lobe epilepsy associated with hippocampal sclerosis. World Neurosurgery 102: 639-650. e2.
[15] Ahmedov ML, Korkmaz TS, Kemerdere R, Yeni SN, Tanriverdi T (2018) Surgical and neurological complications in temporal lobe epilepsy surgery in modern era. Surgical Neurology International 9: 134.
[16] Engel J Jr (1997) Outcome with respect to epileptic seizures. In Engel J Jr, (Ed). Surgical treatment of the epilepsies. New York: Raven Press: 553-571.
[17] Salanova V, Markand O, Worth R (2005) Temporal lobe epilepsy: analysis of failures and the role of reoperation. Acta Neurologica Scandinavica 111: 126-133.
[18] Bonilha L, Kobayashi E, Rorden C, Cendes F, Li LM (2003) Medial temporal lobe atrophy in patients with refractory temporal lobe epilepsy. Journal of Neurology, Neurosurgery, and Psychiatry 74: 1627-1630.
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  • APA Style

    Mamytov Mitalip, Kadyrov Ruslan, Mamytova Elmira. (2021). Modern Problems in the Surgical Treatment of Epilepsy. Clinical Neurology and Neuroscience, 5(1), 5-9. https://doi.org/10.11648/j.cnn.20210501.12

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    ACS Style

    Mamytov Mitalip; Kadyrov Ruslan; Mamytova Elmira. Modern Problems in the Surgical Treatment of Epilepsy. Clin. Neurol. Neurosci. 2021, 5(1), 5-9. doi: 10.11648/j.cnn.20210501.12

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    AMA Style

    Mamytov Mitalip, Kadyrov Ruslan, Mamytova Elmira. Modern Problems in the Surgical Treatment of Epilepsy. Clin Neurol Neurosci. 2021;5(1):5-9. doi: 10.11648/j.cnn.20210501.12

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  • @article{10.11648/j.cnn.20210501.12,
      author = {Mamytov Mitalip and Kadyrov Ruslan and Mamytova Elmira},
      title = {Modern Problems in the Surgical Treatment of Epilepsy},
      journal = {Clinical Neurology and Neuroscience},
      volume = {5},
      number = {1},
      pages = {5-9},
      doi = {10.11648/j.cnn.20210501.12},
      url = {https://doi.org/10.11648/j.cnn.20210501.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20210501.12},
      abstract = {Background: The surgical treatment of epilepsy is widely recognised by neurosurgeons as the most effective method for treating patients with drug-resistant forms of the disease. Objective: To analyse the results of surgical treatments in patients with epileptic seizures, depending on the applied methods of surgery. Methods: A comprehensive clinical examination of the surgical treatments of 112 patients with various forms of drug-resistant epilepsy was carried out. Results: Hemispherectomy was performed in three patients with positive outcomes. Hippocampectomy was performed for four patients. In two patients, the seizures became medically controlled. In the other two cases, the intervals between seizures were longer and seizures tended to occur at night. Extratemporal resection of the epileptogenic focus was performed in 86 patients, 72% percent of whom became seizure-free. Six patients underwent callosotomy, five of whom were then seizure free. One patient’s seizures resumed after 8 months, this case was also drug-resistant. Thirty two patients underwent multiple subpial transection and were followed-up for approximately 5 years. Excellent results were obtained in 20 (62.5%) patients with seizures ceasing. Conclusions: The results of the study showed sufficient efficiency of the applied methods of surgical treatment for various forms of epilepsy.},
     year = {2021}
    }
    

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    T1  - Modern Problems in the Surgical Treatment of Epilepsy
    AU  - Mamytov Mitalip
    AU  - Kadyrov Ruslan
    AU  - Mamytova Elmira
    Y1  - 2021/03/09
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    N1  - https://doi.org/10.11648/j.cnn.20210501.12
    DO  - 10.11648/j.cnn.20210501.12
    T2  - Clinical Neurology and Neuroscience
    JF  - Clinical Neurology and Neuroscience
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    UR  - https://doi.org/10.11648/j.cnn.20210501.12
    AB  - Background: The surgical treatment of epilepsy is widely recognised by neurosurgeons as the most effective method for treating patients with drug-resistant forms of the disease. Objective: To analyse the results of surgical treatments in patients with epileptic seizures, depending on the applied methods of surgery. Methods: A comprehensive clinical examination of the surgical treatments of 112 patients with various forms of drug-resistant epilepsy was carried out. Results: Hemispherectomy was performed in three patients with positive outcomes. Hippocampectomy was performed for four patients. In two patients, the seizures became medically controlled. In the other two cases, the intervals between seizures were longer and seizures tended to occur at night. Extratemporal resection of the epileptogenic focus was performed in 86 patients, 72% percent of whom became seizure-free. Six patients underwent callosotomy, five of whom were then seizure free. One patient’s seizures resumed after 8 months, this case was also drug-resistant. Thirty two patients underwent multiple subpial transection and were followed-up for approximately 5 years. Excellent results were obtained in 20 (62.5%) patients with seizures ceasing. Conclusions: The results of the study showed sufficient efficiency of the applied methods of surgical treatment for various forms of epilepsy.
    VL  - 5
    IS  - 1
    ER  - 

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Author Information
  • Department of Neurosurgery, Kyrgyz State Medical Academy, Kyrgyzstan, Bishkek

  • Department of Neurosurgery, Kyrgyz State Medical Academy, Kyrgyzstan, Bishkek

  • Department of Neurology, Kyrgyz State Medical Academy, Kyrgyzstan, Bishkek

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