Department of Neurology, Neurocritical Care, and Neurorehabilitation, Christian-Doppler University Hospital, Paracelsus Medical University, Centre for Cognitive Neuroscience, Member of EpiCARE.
Neuroscience Institute, Christian-Doppler University Hospital, Paracelsus Medical University, Centre for Cognitive Neuroscience, Salzburg.
Curr Opin Neurol. 2024 Apr 1;37(2):141-151. doi: 10.1097/WCO.0000000000001253. Epub 2024 Feb 14.
To review the current practices and evidence for the diagnostic accuracy and the benefits of presurgical evaluation.
Preoperative evaluation of patients with drug-resistant focal epilepsies and subsequent epilepsy surgery leads to a significant proportion of seizure-free patients. Even those who are not completely seizure free postoperatively often experience improved quality of life with better social integration. Systematic reviews and meta-analysis on the diagnostic accuracy are available for Video-electroencephalographic (EEG) monitoring, magnetic resonance imaging (MRI), electric and magnetic source imaging, and functional MRI for lateralization of language and memory. There are currently no evidence-based international guidelines for presurgical evaluation and epilepsy surgery.
Presurgical evaluation is a complex multidisciplinary and multiprofessional clinical pathway. We rely on limited consensus-based recommendations regarding the required staffing or methodological expertise in epilepsy centers.
回顾药物难治性局灶性癫痫患者的术前评估的现状、评估的准确性以及其获益。
对药物难治性局灶性癫痫患者进行术前评估并进行后续癫痫手术，可使很大一部分患者无癫痫发作。即使术后未完全无癫痫发作的患者，其生活质量也常得到改善，社会融合度更好。目前已有关于视频脑电图（EEG）监测、磁共振成像（MRI）、电和磁共振源成像、语言和记忆功能 MRI 定位的诊断准确性的系统评价和荟萃分析。但目前尚无关于术前评估和癫痫手术的循证国际指南。
术前评估是一个复杂的多学科和多专业的临床路径。我们仅依靠基于共识的有限建议来确定癫痫中心所需的人员配备或方法学专业知识。
