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过去十年的癫痫手术:进展与争议

Epilepsy Surgery in the Last 10 Years: Advancements and Controversies.

作者信息

Gonzalez-Martinez Jorge A

机构信息

University of Pittsburgh, USA.

出版信息

Epilepsy Curr. 2025 Jul 9:15357597251344166. doi: 10.1177/15357597251344166.


DOI:10.1177/15357597251344166
PMID:40655903
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12240976/
Abstract

The past decade has witnessed a transformative evolution in epilepsy surgery, marked by the introduction and maturation of the so-called "minimally invasive interventions," neuromodulation strategies, and personalized surgical approaches. These developments have redefined treatment paradigms for drug-resistant epilepsy, offering safer, more targeted, and sometimes more effective alternatives to traditional open resections. The 2025 AES Surgery Symposium served as a platform for synthesizing the state-of-the-art in this dynamic field, highlighting not only the significant strides made in surgical and neurotechnological innovation but also the unresolved controversies that continue to shape clinical practice. This review aims to distill key themes from the symposium, including emerging surgical techniques, the resurgence of stereo-electroencephalography (SEEG)-guided thermocoagulation, the further integration of neuromodulation into mainstream epilepsy care, and the future of individualized surgical planning through advanced imaging and connectomics. While these innovations hold remarkable promise, their efficacy, accessibility, and long-term impact require rigorous scrutiny and global discourse.

摘要

在过去十年中,癫痫手术经历了变革性的发展,其标志是所谓的“微创干预”、神经调节策略和个性化手术方法的引入与成熟。这些进展重新定义了耐药性癫痫的治疗模式,为传统开放性切除术提供了更安全、更具针对性且有时更有效的替代方案。2025年美国癫痫学会(AES)手术研讨会成为了一个综合该动态领域最新技术水平的平台,不仅突出了手术和神经技术创新方面取得的重大进展,还强调了持续影响临床实践的未解决争议。本综述旨在提炼研讨会的关键主题,包括新兴的手术技术、立体定向脑电图(SEEG)引导下热凝术的复兴、神经调节进一步融入主流癫痫治疗以及通过先进成像和连接组学进行个性化手术规划的未来。虽然这些创新前景广阔,但其疗效、可及性和长期影响需要严格审查和全球范围内的讨论。

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本文引用的文献

[1]
Hemispherectomy for dominant hemisphere Rasmussen's Encephalitis - how late is too late?

Epilepsy Behav Rep. 2024-6-21

[2]
Hemispheric surgery in children: perisylvian technique.

Neurosurg Focus Video. 2024-7-1

[3]
Thalamic stereoelectroencephalography for neuromodulation target selection: Proof of concept and review of literature of pulvinar direct electrical stimulation.

Epilepsia. 2024-6

[4]
The changing landscape of palliative epilepsy surgery for Lennox Gastaut Syndrome.

Front Neurol. 2024-3-7

[5]
Defining benchmark outcomes for mesial temporal lobe epilepsy surgery: A global multicenter analysis of 1119 cases.

Epilepsia. 2024-5

[6]
Laser amygdalohippocampotomy reduces contralateral hippocampal sub-clinical activity in bitemporal epilepsy: A case illustration of responsive neurostimulator ambulatory recordings.

Epilepsy Behav Rep. 2023-12-1

[7]
Stereoelectroencephalography-guided laser ablation in neocortical epilepsy: Electrophysiological correlations and outcome.

Epilepsia. 2023-11

[8]
Neuro-stimulation in focal epilepsy: A systematic review and meta-analysis.

Epilepsy Behav. 2023-5

[9]
Laser Interstitial Thermal Therapy for Epilepsy.

Neurosurg Clin N Am. 2023-4

[10]
Cost-effectiveness of invasive monitoring strategies in epilepsy surgery.

J Neurosurg. 2023-7-1

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