engleski

Medically Intractable Epilepsy – our Experiences with Surgical Treatment

Surgical methods have recently been ever more introduced in current therapy of epilepsies. The elective criteria are a history of failure to improve the quality of life with long-term medical treatment, and exact EEG and radiological (NMR and CT) determination of the focus. Most important is the patient’ s request for such a treatment. The most common procedure is focus ablation, then disconnection of the focus and a combination of the two procedures. The incidence of these procedures is expected to be 2 patients per 100 000 a year. During a 6-year period, we operated on 12 patients. The mean duration of treatment before deciding on the operation was 7.5 years. There were 5 female and 7 male patients, mean age 23.5 years. Secondary generalized epileptic attacks were recorded in 10, and primary generalized epilepsy and focal epilepsy in one case each. Radiological (NMR and CT) findings showed benign tumours in 3, arachnoidal cysts in 3, one small AVM with gliosis in one, and focal (hippocampal) gliosis (sclerosis) in 5 cases. In all patients, the procedure consisted of ablation of the focus. Epileptic seizures were substantially reduced in 9 cases with prolonged ant epileptic drugs therapy, in one case ant epileptic drugs therapy could be reduced, and in one case it was discontinued without seizures ; in one case the operation did no help at all. The complications included one hemiparesis (which has been gradually improving) and one hemianopsia. Our results speak in favour of surgical therapy in carefully selected patients, and should encourage neurologists to consider surgical treatment more often.

Epilepsy; Surgical treatment

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