Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom, and Chalfont Centre for Epilepsy.
Department of Epileptology, University of Bonn Medical Center, Bonn, Germany.
Ann Neurol. 2018 Apr;83(4):676-690. doi: 10.1002/ana.25205. Epub 2018 Apr 10.
Neurosurgery is an underutilized treatment that can potentially cure drug-refractory epilepsy. Careful, multidisciplinary presurgical evaluation is vital for selecting patients and to ensure optimal outcomes. Advances in neuroimaging have improved diagnosis and guided surgical intervention. Invasive electroencephalography allows the evaluation of complex patients who would otherwise not be candidates for neurosurgery. We review the current state of the assessment and selection of patients and consider established and novel surgical procedures and associated outcome data. We aim to dispel myths that may inhibit physicians from referring and patients from considering neurosurgical intervention for drug-refractory focal epilepsies. Ann Neurol 2018;83:676-690.
神经外科是一种未充分利用的治疗方法，它可能治愈药物难治性癫痫。仔细的多学科术前评估对于选择患者和确保最佳结果至关重要。神经影像学的进步改善了诊断，并指导了手术干预。侵入性脑电图可评估复杂患者，否则这些患者将不符合神经外科手术的条件。我们回顾了目前患者评估和选择的状况，并考虑了已确立和新的手术程序及其相关的结果数据。我们旨在消除可能使医生不愿推荐和患者不愿考虑神经外科手术治疗药物难治性局灶性癫痫的误解。神经病学杂志 2018 年；83：676-690.
