Surgical treatment of refractory epilepsy

  Epilepsy, commonly known as “crohn’s disease”, is a common clinical condition in neurology, pediatrics and neurosurgery, with a complex etiology, and has been listed as one of the ten most difficult diseases in the medical community. If treatment is not timely or regular, it can cause varying degrees of physical damage, mental or psychosocial impairment to patients, preventing them from socializing, working, learning, improving their quality of life, and even having life-threatening conditions.  To further standardize the diagnosis and treatment of epilepsy and improve the quality of life of epileptic patients, neurology, pediatrics and neurosurgery individualize diagnosis and drug or surgical treatment for specific cases. In addition to general EEG examinations, the neurology and pediatrics departments have opened special EEG monitoring beds and introduced long-range EEG and video EEG machines, which provide a basis for precise lateralization and localization of epileptogenic foci and diagnosis of epilepsy types through long-time EEG recording and behavioral video for relevant patients, thus better facilitating the selection of antiepileptic drugs. After systematic and regular drug treatment, most patients achieved good results. However, 20%-30% of patients with epilepsy eventually develop resistance to antiepileptic drugs, resulting in drug-refractory intractable epilepsy with poor or ineffective seizure control. In these cases, neurology and pediatrics actively collaborate with neurosurgery to surgically treat the appropriate patient.  Appropriate surgical procedures can reduce or even completely control seizures, and neurosurgery introduced an intraoperative EEG monitor as early as 2001 to treat lesions or epileptogenic foci with good results by monitoring areas of brain tissue discharges during surgery and using a variety of surgical approaches. In recent years, the relevant staff of neurology, pediatrics and neurosurgery have strengthened their communication and collaboration and reached a certain consensus on the formal treatment of epilepsy. Surgical treatment is generally the preferred method for secondary epilepsy (symptomatic epilepsy), and after careful localization and evaluation of primary epilepsy where drugs are ineffective, surgical treatment is chosen for suitable cases. Multidisciplinary collaboration has promoted the level of epilepsy treatment at our hospital to a higher level.  With the development of medical technology, the introduction of new antiepileptic drugs and the application of surgical methods have led to increasing efficiency of epilepsy treatment, improving the quality of life of epilepsy patients, and their prognosis is getting better.