Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26017774
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Epilepsy+Behav
2015 ; 47
(ä): 24-33
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Minimally invasive surgical approaches for temporal lobe epilepsy
#MMPMID26017774
Chang EF
; Englot DJ
; Vadera S
Epilepsy Behav
2015[Jun]; 47
(ä): 24-33
PMID26017774
show ga
Surgery can be a highly effective treatment for medically refractory temporal
lobe epilepsy (TLE). The emergence of minimally invasive resective and
nonresective treatment options has led to interest in epilepsy surgery among
patients and providers. Nevertheless, not all procedures are appropriate for all
patients, and it is critical to consider seizure outcomes with each of these
approaches, as seizure freedom is the greatest predictor of patient quality of
life. Standard anterior temporal lobectomy (ATL) remains the gold standard in the
treatment of TLE, with seizure freedom resulting in 60-80% of patients. It is
currently the only resective epilepsy surgery supported by randomized controlled
trials and offers the best protection against lateral temporal seizure onset.
Selective amygdalohippocampectomy techniques preserve the lateral cortex and
temporal stem to varying degrees and can result in favorable rates of seizure
freedom but the risk of recurrent seizures appears slightly greater than with
ATL, and it is not clear whether neuropsychological outcomes are improved with
selective approaches. Stereotactic radiosurgery presents an opportunity to avoid
surgery altogether, with seizure outcomes now under investigation. Stereotactic
laser thermo-ablation allows destruction of the mesial temporal structures with
low complication rates and minimal recovery time, and outcomes are also under
study. Finally, while neuromodulatory devices such as responsive
neurostimulation, vagus nerve stimulation, and deep brain stimulation have a role
in the treatment of certain patients, these remain palliative procedures for
those who are not candidates for resection or ablation, as complete seizure
freedom rates are low. Further development and investigation of both established
and novel strategies for the surgical treatment of TLE will be critical moving
forward, given the significant burden of this disease.
free
free
free
