Surgery for drug-resistant epilepsy

Resective surgery is a technique used for the surgical treatment of patients with focal epilepsies that do not respond to pharmacological treatment. If the seizure ‘focus’ can be localized with imaging techniques (MRI, PET, SPECT) and electroencephalography, it can be removed surgically, achieving a good control of epilepsy in a high number of patients.

 

If the origin of the epilepsy cannot be identified or seizures are diffuse or multifocal, treatment with vagus nerve stimulation (VNS) can decrease epileptic seizures and improve the quality of life of these patients.

 

VNS requires the implantation of an electrode around the vagus nerve at the cervical level. The connection of this electrode to a pulse generator usually implanted in the chest, may reduce the number of epileptic seizures and improve the quality of life in patients with drug-resistant epilepsy. With this therapy, the electrical impulses are transmitted backwards to the brain causing a desynchronization of the epileptogenic brain activity.

Treatments:

 

Microsurgical treatment of drug-resistant epilepsy:

amygdalohippocampectomy

Vagus nerve stimulation

Deep brain stimulation (DBS) for Parkinson’s disease, movement disorders, obsessive-compulsive disorder and chronic pain

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