Hussain Ibrahim, Kocharian Gary, Tosi Umberto, Schwartz Theodore H, Hoffman Caitlin E
Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York, USA.
Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York, USA.
World Neurosurg. 2020 Jul;139:750-761. doi: 10.1016/j.wneu.2020.03.033.
The diagnostic and surgical management of epilepsy has made enormous strides over the past 3 decades, concomitant with advances in technology and electrophysiologic understanding of neuronal connectivity. Distinct zones have been identified within this network that each communicate and play a role in the genesis of seizures. Invasive and noninvasive modalities for defining the epileptogenic lesion or region have been able to more accurately determine which patients are optimal candidates for treatment when their seizures are refractory to conventional conservative management. Ablative, palliative, and disconnecting procedures have been developed as alternatives for traditional open resection techniques, and in recent studies, they have shown excellent seizure control and mitigation of complications. In this review, we discuss the evolution of these advancements in the management of epilepsy and provide an overview of current and future neurosurgical therapeutic modalities.
在过去30年里，随着技术进步以及对神经元连接的电生理理解的深入，癫痫的诊断和外科治疗取得了巨大进展。在这个网络中已确定了不同的区域，每个区域都相互连通并在癫痫发作的发生中发挥作用。当癫痫发作对传统保守治疗无效时，用于确定致痫病变或区域的有创和无创方法能够更准确地确定哪些患者是最佳治疗对象。已开发出消融、姑息和离断手术作为传统开放性切除技术的替代方法，并且在最近的研究中，它们已显示出对癫痫发作的良好控制以及并发症的减轻。在本综述中，我们讨论癫痫治疗中这些进展的演变，并概述当前和未来的神经外科治疗方式。
