The Preoperative Evaluation of Drug-Resistant Epilepsy

Pediatr Neurol. 2020 Nov:112:78-83. doi: 10.1016/j.pediatrneurol.2020.05.010. Epub 2020 Jun 27.

Abstract

Antiepileptic drugs afford good seizure control for approximately 70% of individuals with epilepsy. Epilepsy surgery is extremely helpful for appropriate individuals with drug resistance. Since antiquity, trephination was a crude and invasive technique to manage epilepsy. The late 1800s saw the advent of a more evidence-based approach with attempts to define seizure foci and determine areas of function. Seizure localization initially required direct brain stimulation during surgery before resection. Fortunately, improved knowledge of seizure semiology and advancements in preoperative investigations have enabled epilepsy specialists to better analyze the benefit of seizure reduction versus risk of functional harm. This preoperative phase and the investigative techniques used to analyze surgical candidacy will be discussed in this article.

Keywords: Epilepsy; Epilepsy surgery; Functional imaging; Preoperative epilepsy evaluation.

Publication types

  • Review

MeSH terms

  • Child
  • Congresses as Topic
  • Drug Resistant Epilepsy / diagnosis*
  • Humans
  • Neuroimaging* / methods
  • Neuroimaging* / standards
  • Neurophysiological Monitoring* / methods
  • Neurophysiological Monitoring* / standards
  • Neurosurgical Procedures* / methods
  • Neurosurgical Procedures* / standards
  • Preoperative Care* / methods
  • Preoperative Care* / standards