Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery

Sibhi Ganapathy; Rajesh Nair

doi:doi:10.11648/j.ijn.20200402.12

| Peer-Reviewed

Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery

Sibhi Ganapathy, Rajesh Nair

Published in International Journal of Neurosurgery (Volume 4, Issue 2)

Received: 13 May 2020 Accepted: 22 June 2020 Published: 28 July 2020

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Epilepsy surgery has been rapidly progressing over the last decade or so, with many previously untreatable conditions now satisfactorily managed to allow improved quality of life and seizure control without excessive medication and debilitating neurological deficits. We present a brief recap on accepted axioms of epilepsy surgery with a look at the future with a short summary of seizure disorder itself and the various management options. The article is directed at general physicians and Internalists who deal with epilepsy on a daily basis. Many have been exasperated by drug recalcitrant epilepsy and have tried with limited success to manage the condition medically. Many are not aware of the speciality of epilepsy surgery, which as mentioned above has made great strides in seizure control over the last decade. The piece also adds emphasis on diagnosis, seizure semiology and detection along with post procedure analysis and evaluation of efficacy. This has been added to assist the general physician in assessing the disease appropriately and referring the disease correctly to ensure proper diagnosis and treatment early. The authors hope that this piece helps sensitise the physicians to the existence of epilepsy surgery, so that they will refer their patient more and more to neurosurgeons for better care and results to their patients.

Published in	International Journal of Neurosurgery (Volume 4, Issue 2)
DOI	10.11648/j.ijn.20200402.12
Page(s)	22-33
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), 2024. Published by Science Publishing Group

Keywords

Drug Recalcitrant Epilepsy, Intractable Epilepsy, Epilepsy Surgery, Temporal Love Epilepsy

References

[1]	Maton BM, Kuniecky RI: Proton MRS: N-acetyl aspartate, creatine, and choline. Adv Neurol 83: 253-259; 2000.
[2]	Devinsky O, Pacia S: Epilepsy surgery. Neurology clinics 11: 951-971; 1993.
[3]	Szelies B, Pawlik G et al: MRI guided flumazenil and FDG –PET in temporal lobe epilepsy, Neuroimage 3: 109-118; 1996.
[4]	Ho SS, Berkovic SF et al: Comparison of Ictal SPECT and interictal PET in the presurgical evaluation of temporal lobe epilepsy, Annals of neurology 347: 738-745; 2000.
[5]	Wiebe et al: Utility of temporal lobe surgery for intractable epilepsy vs. Continued treatment with antiepileptic drugs, NEJM 12: 131-137; 2001.
[6]	Spencer et al: Anteromedial Temporal Resection, NEJM 10: 123-132; 2006.
[7]	Clusmann H, Schramm j, Kral T et al: Prognostic factors and outcome after different types of resection for temporal lobe epilepsy. J. Neurosurg. 97: 1131-1141; 2002.
[8]	Tripathi M, Garg A, Gaikwad CS, et al: Intra operative electrocorticography in Lesional epilepsy. World Neurosurgery 19: 1222-1245; 2009.
[9]	Oppenheimer DR, Griffith HB: Persistent intracranial bleeding as a complication of hemispherectomy. J Neurol Neurosurg Psychiatry 29: 229–240, 1966.
[10]	Sarat Chandra P, Padma Vasantha M, Gaikwad S et al: Hemispherotomy for intractable epilepsy. World Neurosurgery. 23: 234-241; 2008.
[11]	Murphy M, Smith PD, Wood M, et al. Surgery for temporal lobe epilepsy associated with mesial temporal sclerosis in the older patient: a long-term follow-up. Epilepsia 2010; 51: 1024–9.
[12]	Dunkley C, Kung J, Scott RC, et al. Epilepsy surgery in children under 3 years. Epilepsy Res 2011; 93: 96–106.
[13]	Téllez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: A systematic review and meta-analysis. Brain 2005; 128: 1188–98.
[14]	Sperling MR, Feldman H, Kinman J, et al. Seizure control and mortality in epilepsy. Ann Neurol 1999; 46: 45–50.
[15]	Choi H, Sell RL, Lenert L, et al. Epilepsy surgery for pharmacoresistant temporal lobe epilepsy: a decision analysis. JAMA 2008; 300: 2497–505.
[16]	Wiebe S, Jette N. Epilepsy surgery utilization: Who, when, where, and why? Curr Opin Neurol 2012; 25: 187–93.
[17]	Hamiwka LD, Macrodimitris S, Tellez-Zenteno J, et al. Social outcomes after temporal or extra-temporal epilepsy surgery: a systematic review. Epilepsia 2011; 52: 870–9.
[18]	35. Wiebe S, Gafni A, Blume WT, et al. An economic evaluation of surgery for temporal lobe epilepsy. J Epilepsy 1995; 8: 227–35.
[19]	Bowen JM, Snead OC, Chandra K, et al. Epilepsy care in Ontario: an economic analysis of increasing access to epilepsy surgery. Ont Health Technol Assess Ser 2012; 12: 1–41.
[20]	Téllez-Zenteno JF, Hernández Ronquillo L, Moien-Afshari F, et al. Surgical outcomes in lesional and non-lesional epilepsy: a systematic review and meta-analysis. Epilepsy Res 2010; 89: 310–8.
[21]	Téllez-Zenteno JF, Dhar R, Hernández-Ronquillo L, et al. Long-term outcomes in epilepsy surgery: antiepileptic drugs, mortality, cognitive and psychosocial aspects. Brain 2007; 130: 334–345.
[22]	Spencer SS, Berg AT, Vickrey BG, et al. Health-related quality of life over time since resective epilepsy surgery. Ann Neurol 2007; 62: 327–34
[23]	Hader WJ, Tellez-Zenteno J, Metcalfe A, et al. Complications of epilepsy surgery — a systematic review of focal surgical resections and invasive EEG monitoring. Epilepsia 2013; 54: 840–7.
[24]	Sherman EM, Wiebe S, Fay-McClymont TB, et al. Neuropsychological outcomes after epilepsy surgery: systematic review and pooled estimates. Epilepsia 2011; 52: 857–69.
[25]	LangUtt JT, Westerveld M, Hamberger MJ, et al. Worsening of quality of life after epilepsy surgery: effect of seizures and memory decline. Neurology 2007; 68: 1988–94 Labiner DM, Bagic AI, Herman ST, et al. Essential services, personnel, and facilities in specialized epilepsy centers — revised 2010 guidelines. Epilepsia 2010; 51: 2322–33.
[26]	Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on ClassiUcation and Terminology, 2005–2009. Epilepsia 2010; 51: 676–85.
[27]	Cross JH, Jayakar P, Nordli D, et al. Proposed criteria for referral and evaluation of children for epilepsy surgery: recommendations of the Subcommission for Pediatric Epilepsy Surgery. Epilepsia 2006; 47: 952–9.
[28]	Helmstaedter C, Kurthen M, Lux S, et al. Chronic epilepsy and cognition: a longitudinal study in temporal lobe epilepsy. Ann Neurol 2003; 54: 425–32 Jette N, Quan H, Tellez-Zenteno JF, et al. Development of an online tool to determine appropriateness for an epilepsy surgery evaluation. Neurology 2012; 79: 1084–93.
[29]	Haneef Z, Stern J, Dewar S, et al. Referral pattern for epilepsy surgery after evidence-based recommendations: a retrospective study. Neurology 2010; 75: 699–704.

Cite This Article

Plain Text BibTeX RIS

APA Style

Sibhi Ganapathy, Rajesh Nair. (2020). Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery. International Journal of Neurosurgery, 4(2), 22-33. https://doi.org/10.11648/j.ijn.20200402.12

Copy | Download

ACS Style

Sibhi Ganapathy; Rajesh Nair. Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery. Int. J. Neurosurg. 2020, 4(2), 22-33. doi: 10.11648/j.ijn.20200402.12

Copy | Download

AMA Style

Sibhi Ganapathy, Rajesh Nair. Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery. Int J Neurosurg. 2020;4(2):22-33. doi: 10.11648/j.ijn.20200402.12

Copy | Download

@article{10.11648/j.ijn.20200402.12,
  author = {Sibhi Ganapathy and Rajesh Nair},
  title = {Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery},
  journal = {International Journal of Neurosurgery},
  volume = {4},
  number = {2},
  pages = {22-33},
  doi = {10.11648/j.ijn.20200402.12},
  url = {https://doi.org/10.11648/j.ijn.20200402.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20200402.12},
  abstract = {Epilepsy surgery has been rapidly progressing over the last decade or so, with many previously untreatable conditions now satisfactorily managed to allow improved quality of life and seizure control without excessive medication and debilitating neurological deficits. We present a brief recap on accepted axioms of epilepsy surgery with a look at the future with a short summary of seizure disorder itself and the various management options. The article is directed at general physicians and Internalists who deal with epilepsy on a daily basis. Many have been exasperated by drug recalcitrant epilepsy and have tried with limited success to manage the condition medically. Many are not aware of the speciality of epilepsy surgery, which as mentioned above has made great strides in seizure control over the last decade. The piece also adds emphasis on diagnosis, seizure semiology and detection along with post procedure analysis and evaluation of efficacy. This has been added to assist the general physician in assessing the disease appropriately and referring the disease correctly to ensure proper diagnosis and treatment early. The authors hope that this piece helps sensitise the physicians to the existence of epilepsy surgery, so that they will refer their patient more and more to neurosurgeons for better care and results to their patients.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery
AU  - Sibhi Ganapathy
AU  - Rajesh Nair
Y1  - 2020/07/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ijn.20200402.12
DO  - 10.11648/j.ijn.20200402.12
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 22
EP  - 33
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20200402.12
AB  - Epilepsy surgery has been rapidly progressing over the last decade or so, with many previously untreatable conditions now satisfactorily managed to allow improved quality of life and seizure control without excessive medication and debilitating neurological deficits. We present a brief recap on accepted axioms of epilepsy surgery with a look at the future with a short summary of seizure disorder itself and the various management options. The article is directed at general physicians and Internalists who deal with epilepsy on a daily basis. Many have been exasperated by drug recalcitrant epilepsy and have tried with limited success to manage the condition medically. Many are not aware of the speciality of epilepsy surgery, which as mentioned above has made great strides in seizure control over the last decade. The piece also adds emphasis on diagnosis, seizure semiology and detection along with post procedure analysis and evaluation of efficacy. This has been added to assist the general physician in assessing the disease appropriately and referring the disease correctly to ensure proper diagnosis and treatment early. The authors hope that this piece helps sensitise the physicians to the existence of epilepsy surgery, so that they will refer their patient more and more to neurosurgeons for better care and results to their patients.
VL  - 4
IS  - 2
ER  -

Copy | Download

Author Information

Sibhi Ganapathy

Department of Neurosurgery, Kasturba Medical College & Hospital, Manipal University, Manipal, India
Rajesh Nair

Department of Neurosurgery, Kasturba Medical College & Hospital, Manipal University, Manipal, India

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Sibhi Ganapathy, Rajesh Nair. (2020). Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery. International Journal of Neurosurgery, 4(2), 22-33. https://doi.org/10.11648/j.ijn.20200402.12

Copy | Download

ACS Style

Sibhi Ganapathy; Rajesh Nair. Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery. Int. J. Neurosurg. 2020, 4(2), 22-33. doi: 10.11648/j.ijn.20200402.12

Copy | Download

AMA Style

Sibhi Ganapathy, Rajesh Nair. Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery. Int J Neurosurg. 2020;4(2):22-33. doi: 10.11648/j.ijn.20200402.12

Copy | Download

@article{10.11648/j.ijn.20200402.12,
  author = {Sibhi Ganapathy and Rajesh Nair},
  title = {Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery},
  journal = {International Journal of Neurosurgery},
  volume = {4},
  number = {2},
  pages = {22-33},
  doi = {10.11648/j.ijn.20200402.12},
  url = {https://doi.org/10.11648/j.ijn.20200402.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20200402.12},
  abstract = {Epilepsy surgery has been rapidly progressing over the last decade or so, with many previously untreatable conditions now satisfactorily managed to allow improved quality of life and seizure control without excessive medication and debilitating neurological deficits. We present a brief recap on accepted axioms of epilepsy surgery with a look at the future with a short summary of seizure disorder itself and the various management options. The article is directed at general physicians and Internalists who deal with epilepsy on a daily basis. Many have been exasperated by drug recalcitrant epilepsy and have tried with limited success to manage the condition medically. Many are not aware of the speciality of epilepsy surgery, which as mentioned above has made great strides in seizure control over the last decade. The piece also adds emphasis on diagnosis, seizure semiology and detection along with post procedure analysis and evaluation of efficacy. This has been added to assist the general physician in assessing the disease appropriately and referring the disease correctly to ensure proper diagnosis and treatment early. The authors hope that this piece helps sensitise the physicians to the existence of epilepsy surgery, so that they will refer their patient more and more to neurosurgeons for better care and results to their patients.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery
AU  - Sibhi Ganapathy
AU  - Rajesh Nair
Y1  - 2020/07/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ijn.20200402.12
DO  - 10.11648/j.ijn.20200402.12
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 22
EP  - 33
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20200402.12
AB  - Epilepsy surgery has been rapidly progressing over the last decade or so, with many previously untreatable conditions now satisfactorily managed to allow improved quality of life and seizure control without excessive medication and debilitating neurological deficits. We present a brief recap on accepted axioms of epilepsy surgery with a look at the future with a short summary of seizure disorder itself and the various management options. The article is directed at general physicians and Internalists who deal with epilepsy on a daily basis. Many have been exasperated by drug recalcitrant epilepsy and have tried with limited success to manage the condition medically. Many are not aware of the speciality of epilepsy surgery, which as mentioned above has made great strides in seizure control over the last decade. The piece also adds emphasis on diagnosis, seizure semiology and detection along with post procedure analysis and evaluation of efficacy. This has been added to assist the general physician in assessing the disease appropriately and referring the disease correctly to ensure proper diagnosis and treatment early. The authors hope that this piece helps sensitise the physicians to the existence of epilepsy surgery, so that they will refer their patient more and more to neurosurgeons for better care and results to their patients.
VL  - 4
IS  - 2
ER  -

Copy | Download