Managing Epilepsy III: Surgery for Intractable Epilepsy.
Jeffrey G. Ojemann, MD
University of Washington School of Medicine
Director of Epilepsy Surgery
Children's Hospital and regional Medical Center
Surgical treatment for intractable seizures is a well accepted, and effective option for patients with focal epilepsy. An identified focus (which can be a lesion, hippocampal sclerosis, or a diseased hemisphere) with acceptable surgical risks can lead to good outcomes when electroencephalography (EEG) and imaging data correspond. Even in the absence of magnetic resonance imaging (MRI) findings, strong EEG localization is associated with good outcome. The various surgically treatable epilepsies are discussed along with a discussion of groups of patients that can be targeted for good outcomes if an epilepsy program is being developed. Temporal lobectomy is described in detail as the mainstay of surgery for epilepsy. Extratemporal surgeries also have good outcomes in appropriate circumstances.
EEG, MRI, review, seizures, temporal lobe