Surgical modalities and indications for epilepsy surgical treatment

       As medical conditions improve and medical technology advances, more and more epilepsy patients can be treated surgically. The following is a description of the surgical procedures and indications for epilepsy surgery: Epilepsy surgery and indications for cerebral cortical resection of epileptogenic lesions: The appropriate candidates for this surgery are those who are over 5 years of age and have frequent seizures that affect their daily life and work. The lesion is located in the cerebral cortex, and the localization is clear and consistent with clinical manifestations, EEG and EEG topography.  The seizures could not be controlled despite regular drug treatment. The lesion causing epilepsy is not located in the important functional areas of the Cosmos. The total efficiency of this procedure is about 85%.  Like cerebrovascular malformation sometimes develops to the whole cerebral hemisphere, it is extremely difficult to remove the lesion completely, therefore, this surgery can only reduce the number of seizures or supplement with a small amount of medication to control them, however, this surgery is the one with the best results in treating epilepsy.  The surgical procedure and indications for epilepsy surgical treatment of one side of the temporal lobe resection: Suitable candidates for this procedure are those who have mild seizures, such as complaints of sudden visual inability to see and smell a strange smell; or suddenly get up from bed and go out and walk around, but their consciousness is mostly unimpaired.  Sometimes it can also manifest as unexplained fear, anxiety, slowness of speech, emotional indifference, and reduced activity After multiple EEG examinations, the epileptogenic focus is confirmed to be located on one side, and a limited lesion is confirmed by CT or MRI. The procedure can result in improvement of epilepsy in 80% to 90% of patients.  However, if the epileptogenic focus exceeds that estimated preoperatively or intraoperatively, the surgical results are less satisfactory.  The patient has a clear history of perinatal brain injury, manifested by hemiparesis, reduced or even complete loss of hand function, mental retardation, irritability, impulsive behavior, destruction of objects, frequent seizures, and almost complete failure of drug therapy. ), indicating that the lesioned brain is completely degenerated and must be removed.  This procedure may sound scary…but it is actually a “clean sweep” of the patient’s brain. In 88% of patients with epilepsy, symptoms disappear completely in 77% of cases, and only 4.5% of patients do not improve, mostly because of late diagnosis.  The surgical procedure and indications for epilepsy surgery are corpus callosotomy: The corpus callosum is an important structure in the brain, which connects the two hemispheres of the brain. Medical experts have concluded that cutting off the low body of the pie stops the firing pathway from one hemisphere to the other and therefore limits the development of epilepsy.  The procedure is indicated for, drug-dependent intractable epilepsy, where the epileptogenic focus cannot be shown exactly after special examinations such as CT and MRI. Certain patients with severe hemispheric disruption or cortical hypoplasia.  Postoperatively, 60% of seizures are reduced and 40% are only slightly improved or ineffective, but the patient may show postoperative muteness with difficulty in understanding and urinary incontinence, and the vast majority of them can remit on their own after a period of time; therefore, the indications for this procedure should be strictly controlled.  The surgery is performed to cut off the tissue structure under the cerebral meninges, but it does not affect the function of nerve cells to transmit information, therefore, it will not cause hemiplegia or monoplegia, etc. This surgery is suitable for: intractable grand mal seizures, EEG shows severe and extensive abnormalities in bilateral cerebral hemispheres, or CT examination shows extensive atrophy of cerebral hemispheres with multiple epileptogenic regions. The epileptogenic foci are located in important functional areas of the brain. The epileptogenic foci are located in important functional areas of the brain, such as motor centers, speech centers, etc.  Cerebral hemiplegia with infantile seizures. The efficiency of this procedure is about 88%.