Sabzvari Tara, Aflahe Iqbal Muhammed, Ranganatha Akash, Daher Jean C, Freire Isabel, Shamsi Syeda Maham Fatima, Paul Anthony Oriona Vinishia, Hingorani Anusha G, Sinha Aparita S, Nazir Zahra
Medical School, McMaster University, Hamilton, CAN.
General Practice, Muslim Educational Society (MES) Medical College Hospital, Perinthalmanna, IND.
Cureus. 2024 Oct 17;16(10):e71715. doi: 10.7759/cureus.71715. eCollection 2024 Oct.
Epilepsy is a neurological disorder that affects millions of people worldwide, with a significant proportion of patients experiencing drug-resistant epilepsy, where seizures remain uncontrolled despite medical treatment. This review evaluates the latest surgical techniques for managing epilepsy, focusing on their effectiveness, safety, and the ongoing challenges that hinder their broader adoption. We explored various databases including PubMed, Google Scholar, and Cochrane Library to look for relevant literature using the following keywords: Epilepsy, Resective Surgery, Corpus Collectumy, and Antiepileptic Drugs. A total of 54 relevant articles were found and thoroughly explored. Recent advancements in surgical interventions include resective procedures such as anterior temporal lobectomy, corpus callosotomy, and hemispherectomy, which have been particularly effective in reducing seizures for specific types of epilepsy. Minimally invasive techniques, including laser interstitial thermal therapy and focused ultrasound, are increasingly being used, offering promising outcomes for certain patient groups. Additionally, neuromodulation methods such as deep brain stimulation, vagus nerve stimulation, and responsive neurostimulation provide alternative treatment options, especially for patients who are not suitable candidates for resective surgery. Despite these advancements, the full potential of epilepsy surgery is often underutilized due to various challenges. Inconsistent referral practices, a lack of standardized surgical protocols, and significant socioeconomic barriers continue to limit access to these procedures. Addressing these issues through improved referral processes, better education for healthcare providers and patients, and ensuring equitable access to advanced surgical treatments is crucial for optimizing patient outcomes. Future research should focus on overcoming these barriers and assessing long-term outcomes to further enhance the care of patients with epilepsy.
癫痫是一种影响全球数百万人的神经系统疾病，相当一部分患者患有耐药性癫痫，即尽管接受了药物治疗，癫痫发作仍无法得到控制。本综述评估了治疗癫痫的最新手术技术，重点关注其有效性、安全性以及阻碍其更广泛应用的持续挑战。我们检索了包括PubMed、谷歌学术和考克兰图书馆在内的各种数据库，使用以下关键词查找相关文献：癫痫、切除性手术、胼胝体切开术和抗癫痫药物。共找到54篇相关文章并进行了深入研究。手术干预的最新进展包括切除性手术，如前颞叶切除术、胼胝体切开术和大脑半球切除术，这些手术在减少特定类型癫痫的发作方面特别有效。越来越多地使用微创技术，包括激光间质热疗和聚焦超声，为某些患者群体带来了有希望的结果。此外，神经调节方法，如深部脑刺激、迷走神经刺激和反应性神经刺激，提供了替代治疗选择，特别是对于不适合进行切除性手术的患者。尽管有这些进展，但由于各种挑战，癫痫手术的全部潜力往往未得到充分利用。转诊做法不一致、缺乏标准化的手术方案以及重大的社会经济障碍继续限制了这些手术的可及性。通过改善转诊流程、对医疗服务提供者和患者进行更好的教育以及确保公平获得先进的手术治疗来解决这些问题，对于优化患者预后至关重要。未来的研究应专注于克服这些障碍并评估长期结果，以进一步改善癫痫患者的护理。
