Common epilepsy surgical procedures

  At present, the main surgical procedures in epilepsy surgery are 1. Excisional surgery, which is to remove the epileptogenic focus that causes epilepsy, is the most ideal surgical procedure, but only if a clear epileptogenic focus can be found and the epileptogenic focus is located in an unimportant part of the brain and does not cause functional impairment after removal. The common ones are selective hippocampal amygdala resection, anterior temporal lobectomy, and focal resection.  2. Palliative surgery, including corpus callosotomy and multiple subchondral transection, these procedures are aimed at blocking the neural pathways for outward transmission of epileptic discharges and reducing the degree of seizures or disabling seizure types. For example, in a patient with multiple seizure types, one of which is prone to falls and injuries, a corpus callosotomy may be chosen to mitigate a fall-related seizure. The main channel of information exchange is the corpus callosum, a cable-like structure that connects the two hemispheres. Cutting off part of the corpus callosum can interrupt the transmission of epileptic discharges from one hemisphere to the other. Theoretically, corpus callosotomy can only reduce seizures but not cure them, but the wonderful thing is that about 5% of patients have their seizures completely discontinued after corpus callosotomy.  3. Special types of surgery: vagus nerve stimulation, mainly for patients who are not well treated with medication and not suitable for surgery. By stimulating the vagus nerve, it may play an integrative role in different parts or levels of the brain, reducing the excitability of the cerebral cortex and decreasing the frequency of seizures. The overall efficiency is about 50%.