Treatment of epilepsy after brain surgery

  It is not uncommon for seizures to occur after brain surgery due to local scarring and the formation of epileptogenic focal areas for a period of time (about six months) after surgery, among which the incidence of postoperative seizures is quite high for cerebral hemispheric convexity and paraneoplastic meningioma, and is also frequent after surgery for frontoparietal glioma, brain abscess and chronic subdural hematoma. Therefore, after surgery for lesions in and around the motor areas of the cerebral hemispheres, a certain amount of antiepileptic drugs should be routinely taken for one year after surgery, and seizures are still very frequent, and those whose seizures are very frequent or ineffective in control may be considered for surgical treatment.  The dura mater is incised to fully reveal the brain scar area, which is mostly adherent to the dura mater. After separation, the location and extent of the spike-wave area of the epileptic foci are detected in detail with cortical electrodes, and the meningeal scar and its epileptogenic foci are removed together without affecting the main brain functions. If the spike-wave area is still present, it will be removed under the soft membrane until the EEG rhythm is normal. If the epileptogenic foci are near the main functional areas of the brain, the meningoencephalic scar can be excised and the surrounding epileptic areas can be cut with multiple subchondral transverse fibers to cut off the spread of the epileptic foci. Most patients can obtain the effect of seizure disappearance or reduction.