Foldvary N, Bingaman W E, Wyllie E
Department of Neurology, Section of Epilepsy and Sleep Disorders, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Neurol Clin. 2001 May;19(2):491-515. doi: 10.1016/s0733-8619(05)70028-1.
Approximately 30-40% of patients with focal epilepsy continue to have seizures despite appropriate medical therapy. Surgical treatments should be considered in this important subset of patients. Recent advances in neuroimaging technology have revolutionized the identification and evaluation of surgical candidates. The goal of the presurgical evaluation (video EEG monitoring, neuroimaging, and neuropsychological assessment) is to delineate the epileptogenic zone. Surgery is recommended when this has been adequately identified and the proposed procedure is expected to result in a high likelihood of seizure freedom and a low risk of neurologic and cognitive morbidity.
尽管接受了适当的药物治疗，但仍有大约30%-40%的局灶性癫痫患者继续发作。对于这一重要的患者亚群，应考虑手术治疗。神经影像学技术的最新进展彻底改变了手术候选者的识别和评估方式。术前评估（视频脑电图监测、神经影像学和神经心理学评估）的目标是明确癫痫发作起始区。当已充分识别该区域且预期拟行手术能带来高无发作可能性和低神经及认知并发症风险时，建议进行手术。
