Surgical Management of Drug Resistant Epilepsy

Abstract

Background: Epilepsy is a disease of the brain defined by any of the following conditions: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart; One unprovoked (or reflex) seizure with relatively high recurrence risk (i.e., ≥60% (, occurring over the next 10 years; or Diagnosis of an Epilepsy syndrome. Objectives: This work aims to review surgical outcome for drug resistant epilepsy of different causes to identify which patient would get the most benefit. Patients and Methods: Prospective and retrospective study on 20 cases with drug resistant epilepsy at Al-Azhar university hospitals.surgical techniques:Lesionectomy Surgery, corpus Callosotomy Conclusion: The objective of epilepsy surgery is complete seizure control without any resulting post-surgical functional deficits, so presurgical evaluation is to determine whether or not epilepsy surgery can be done and to define its chances of risk and benefit. Surgery can be classified to curative procedures which are performed when tests consistently point to a specific area of the brain where the seizures begin, as the Temporal lobectomy which is the most common type of surgery, Cortical excision, Hemispherectomy and Palliative procedures are performed when a specific area in the brain can’t be determined or when the seizure focus overlaps brain areas critical for movement as Vagus nerve stimulation. Not all people who have done epilepsy surgery are seizure free following surgery, but there is usually a significant decrease in seizures. Some people may have some seizures immediately after surgery but this doesn’t mean that the surgery wasn’t successful.