Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T01:00:59.276Z Has data issue: false hasContentIssue false

Temporal Lobe Epilepsy Surgery: Definition of Candidacy

Published online by Cambridge University Press:  02 December 2014

Michael W. Jones
Affiliation:
Vancouver General Hospital, Vancouver, BC, Canada
Frederick Andermann
Affiliation:
Vancouver General Hospital, Vancouver, BC, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Medical intractability is one of the absolute indications for considering temporal lobe epilepsy surgery. This is a relative concept that has to be highly individualized. It is quite easy to determine when a patient's seizures are fully controlled. On the other hand, “continuing seizures are not necessarily a measure of intractability or disability”. A positive decision to operate would be based on some of the following factors: assurance of a firm diagnosis, seizures that are frequent and disabling, and seizures occurring in patients who are drug refractory to optimal anti-epileptic medications and dosages.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2000

References

1. The Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for the revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 1981; 22: 489501.Google Scholar
2. So, N. Epileptic Auras. In Wylie, E. The Treatment of Epilepsies: Principles and Practices. Philadelphia, Lea & Febiger 1993; Chap. 25; 369377.Google Scholar
3. Hauser, WA, Kurland, LT. The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 1975; 16:166.Google Scholar
4. Kirby, S, Sadler, MR. Injury and death as a result of seizures. Epilepsia 1995; 36(S1); 2528.Google Scholar
5. Baker, GA, Nashef, L, van Hout, BA. Current issues in the management of epilepsy: the impact of frequent seizures on cost of illness, quality of life, and mortality. Epilepsia 1997; 38 (Suppl. 1):S1-S8.Google Scholar
6. Yerby, M. Treatment of epilepsy in pregnancy. In: The Treatment of Epilepsy: Principles and Practice. Philadelphia, Lea & Febiger 1993; Chap. 71; 844857.Google Scholar
7. Weibe, S, Gafni, A, Blume, WT, Girvin, JP. An economic evaluation of surgery for temporal lobe epilepsy. J Epilepsy 1995; 8:227235.Google Scholar
8. King, JT, Sperling, MR, Justica, AC et al. A cost-effectiveness analysis of anterior temporal lobectomy for intractable temporal lobe epilepsy. J Neurosurg 1997; 87(S1):2028.Google Scholar
9. Blume, WT. Temporal lobe epilepsy surgery in childhood: rationale for greater use. Can J Neurol Sci 1997; 24:9598.Google Scholar
10. Mattson, RH, Crammer, JA, Collins, JF, et al. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondary generalized tonic clonic seizures. N Engl J Med 1985; 313:145151.Google Scholar
11. Mattson, RH, et al. A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondary generalized tonic clonic seizures in adults. The Department of Veterans Affairs Epilepsy Cooperative Study No. 264 Group. N Engl J Med 1992; 327(11):765771.Google Scholar
12. Walker, MC, Sander, JW. Difficulties in extrapolating from clinical trial data to clinical practice: the case of anti-epileptic drugs. Neurology 1997; 49(2):333337.Google Scholar
13. Chadwick, DW. An overview of the efficacy and tolerability of new anti-epileptic drugs. Epilepsia 1997; 38(Suppl 1):S59-S61.Google Scholar
14. Boon, P, DeReuck, J, Drieghe, C, et al. Long-term video-EEG monitoring revisited. The value of interictal and ictal video-EEG recording, a follow-up study. Eur Neurol 1994; 34(Suppl. 1):3339.Google Scholar
15. Krahn, LE, Rummans, TA, Sharbrough, FW et al. Pseudoseizures after epilepsy surgery. Psychosomatics 1995; 36(5):487493.Google Scholar
16. Blumer, D, Montouris, G, Herman, B. Psychiatric morbidity in seizure patients on a neurodiagnostic monitoring unit. J Neuropsychiatry Clin Neurosci 1995; 7(4):445456.Google Scholar
17. Benbadis, SR. What can EEG-video monitoring do for you and your patients? J Fla Med Assoc 1997; 84(5):320322.Google Scholar
18. Bebin, EM, Kelly, PJ, Gomez, MR. Surgical treatment for epilepsy in cerebral tuberous sclerosis. Epilepsia 1993; 34(4):651657.Google Scholar