Modern Problems in the Surgical Treatment of Epilepsy

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.