Epilepsy surgery

Epilepsy surgery. Epilepsy surgery is indicated for adults or children with partial, drug-resistant and disabling epilepsy. It has developed over the last few decades through better identification of candidates, advances in imaging and surgical techniques. Main indications are temporal lobe epilepsy associated with hippocampal sclerosis, low-grade glial tumors and focal cortical dysplasia. Pre-surgical assessment is based on clinical, neurophysiological and imaging data which most often allow to carry the surgical indication. A neuropsychological and psychiatric assessment is essential to investigate the comorbidities and evaluate the risk of post-operative decompensation. Intracerebral exploration using stereotactic implanted electrodes (stereo-electroencephalography) may be necessary to identify the epileptogenic zone and define the surgical strategy. Resection surgery (corticectomy or lesionectomy) is the most common procedure. Seizure-free outcome is obtained in 60-80% of patients after surgery, with a low morbidity. These results are maintained over the long term and associated by an improvement in the quality of life and a reduction in the costs of the disease. Best results are observed in young subjects with short epilepsy duration.