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Chapter 18 - Resective Surgery for Medication-Resistant Epilepsy

Published online by Cambridge University Press:  20 August 2020

By
Barbara C. Jobst  and
Krzyszof A. Bujarski
Edited by
John M. Stern ,
Raman Sankar  and
Michael Sperling
John M. Stern
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Raman Sankar
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Michael Sperling
Affiliation:
Jefferson Hospital for Neurosciences, Philadelphia, PA
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Summary

Resective epilepsy surgery is to date the most effective treatment for focal medication-resistant epilepsy. In multiple retrospective studies the median percentage for remaining seizure-free is approximately 60–65%, depending on the epilepsy syndrome [1]. Surgery for epilepsy was pioneered by Penfield in the first part of the twentieth century and has been refined since, with advanced imaging and neurophysiologic recordings [2]. Despite the obvious success, surgery remains underutilized [1,3]. If seizures are focal in onset and medication resistant, which is defined by the ILAE as having failed two anti-epileptic medications at standard doses, surgical evaluation at a specialized centre is indicated [4].

Type
Chapter
Information
Medication-Resistant Epilepsy
Diagnosis and Treatment
 , pp. 198 - 209
Publisher: Cambridge University Press
Print publication year: 2020

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References

Jobst, BC, Cascino, GD. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. J Am Med Assoc 2015;313(3):285–293Google Scholar
Penfield, W, Jasper, H Epilepsy and the Functional Anatomy of the Human Brain. Boston: Little, Brown & Co., 1954.Google Scholar
Haneef, Z, Stern, J, Dewar, S, Engel, J, Jr. Referral pattern for epilepsy surgery after evidence-based recommendations: a retrospective study. Neurology 2010;75(8):699–704Google Scholar
Kwan, P, Arzimanoglou, A, Berg, AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010;51(6):1069–1077Google Scholar
McGonigal, A, Bartolomei, F, Regis, J, et al. Stereoelectroencephalography in presurgical assessment of MRI-negative epilepsy. Brain 2007;130(Pt 12):3169–3183CrossRefGoogle ScholarPubMed
Steinhoff, BJ, Bacher, M, Bucurenciu, I, et al. The impact of guidelines on the quality of MRI diagnostics in adult patients referred to a tertiary epilepsy centre. J Neurol 2013;260(12):3174–3175Google Scholar
Phal, PM, Usmanov, A, Nesbit, GM, et al. Qualitative comparison of 3-T and 1.5-T MRI in the evaluation of epilepsy. Am J Roentgenol 2008;191(3):890–895Google Scholar
De Ciantis, A, Barba, C, Tassi, L, et al. 7T MRI in focal epilepsy with unrevealing conventional field strength imaging. Epilepsia 2016;57(3):445–454CrossRefGoogle ScholarPubMed
Thadani, VM, Siegel, A, Lewis, P, et al. Validation of ictal single photon emission computed tomography with depth encephalography and epilepsy surgery. Neurosurg Rev 2004;27(1):27–33Google Scholar
Spanaki, MV, Spencer, SS, Corsi, M, et al. Sensitivity and specificity of quantitative difference SPECT analysis in seizure localization. J Nucl Med 1999;40(5):730–736Google Scholar
Perissinotti, A, Setoain, X, Aparicio, J, et al. Clinical role of subtraction ictal SPECT coregistered to MR imaging and (18)F-FDG PET in pediatric epilepsy. J Nucl Med 2014;55(7):1099–1105Google Scholar
Sulc, V, Stykel, S, Hanson, DP, et al. Statistical SPECT processing in MRI-negative epilepsy surgery. Neurology 2014;82(11):932–939CrossRefGoogle ScholarPubMed
Knowlton, RC. The role of FDG-PET, ictal SPECT, and MEG in the epilepsy surgery evaluation. Epilepsy Beha 2006;8(1):91–101Google Scholar
Whiting, P, Gupta, R, Burch, J, et al. A systematic review of the effectiveness and cost-effectiveness of neuroimaging assessments used to visualise the seizure focus in people with refractory epilepsy being considered for surgery. Health Technol Assess 2006;10(4):1–250Google Scholar
Task Force on Practice Parameter Imaging Guidelines for International League Against Epilepsy, Commission for Diagnostics, Gaillard, WD, Cross, JH, Duncan, JS, Stefan, H, Theodore, WH. Epilepsy imaging study guideline criteria: commentary on diagnostic testing study guidelines and practice parameters. Epilepsia 2011;52(9):1750–1756Google Scholar
Desai, A, Bekelis, K, Thadani, VM, et al. Interictal PET and ictal subtraction SPECT: sensitivity in the detection of seizure foci in patients with medically intractable epilepsy. Epilepsia 2013;54(2):341–350CrossRefGoogle ScholarPubMed
LoPinto-Khoury, C, Sperling, MR, Skidmore, C, et al. Surgical outcome in PET-positive, MRI-negative patients with temporal lobe epilepsy. Epilepsia 2012;53(2):342–348Google Scholar
Bagic, A. Look back to leap forward: the emerging new role of magnetoencephalography (MEG) in nonlesional epilepsy. Clin Neurophysiol 2016;127(1):60–66CrossRefGoogle ScholarPubMed
Lau, M, Yam, D, Burneo, JG. A systematic review on MEG and its use in the presurgical evaluation of localization-related epilepsy. Epilepsy Res 2008;79(2–3):97–104Google Scholar
Tellez-Zenteno, JF, Hernandez Ronquillo, L, Moien-Afshari, F, Wiebe, S. Surgical outcomes in lesional and non-lesional epilepsy: a systematic review and meta-analysis. Epilepsy Res 2010;89(2–3):310–318Google Scholar
Mittal, S, Barkmeier, D, Hua, J, et al. Intracranial EEG analysis in tumor-related epilepsy: evidence of distant epileptic abnormalities. Clin Neurophysiol 2016;127(1):238–244Google Scholar
Englot, DJ, Han, SJ, Berger, MS, Barbaro, NM, Chang, EF. Extent of surgical resection predicts seizure freedom in low-grade temporal lobe brain tumors. Neurosurgery 2012;70(4):921–928;discussion 928Google Scholar
Surgical Task Force Commission on Therapeutic Strategies of the ILAE, Rosenow, F, Alonso-Vanegas, MA, Baumgartner, C, et al. Cavernoma-related epilepsy: review and recommendations for management–report of the Surgical Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2013;54(12):2025–2035CrossRefGoogle ScholarPubMed
Englot, DJ, Han, SJ, Lawton, MT, Chang, EF. Predictors of seizure freedom in the surgical treatment of supratentorial cavernous malformations. J Neurosurg 2011;115(6):1169–1174Google Scholar
Duffau, H. Brain mapping in tumors: intraoperative or extraoperative? Epilepsia 2013;54(Suppl 9):79–83Google Scholar
Yang, PF, Pei, JS, Zhang, HJ, et al. Long-term epilepsy surgery outcomes in patients with PET-positive, MRI-negative temporal lobe epilepsy. Epilepsy Behav 2014;41:91–97CrossRefGoogle ScholarPubMed
Schijns, OE, Hoogland, G, Kubben, PL, Koehler, PJ. The start and development of epilepsy surgery in Europe: a historical review. Neurosurg Rev 2015;38(3):447–461Google Scholar
Serletis, D, Bulacio, J, Bingaman, W, Najm, I, Gonzalez-Martinez, J. The stereotactic approach for mapping epileptic networks: a prospective study of 200 patients. J Neurosurg 2014;121(5):1239–1246Google Scholar
Sperling, MR, Guina, L. The necessity for sphenoidal electrodes in the presurgical evaluation of temporal lobe epilepsy: pro position. Clin Neurophysiol 2003;20(5):299–304Google Scholar
Singh, S, Sandy, S, Wiebe, S. Ictal onset on intracranial EEG: do we know it when we see it? State of the evidence. Epilepsia 2015;56(10):1629–1638Google Scholar
Pacia, SV, Ebersole, JS. Intracranial EEG substrates of scalp ictal patterns from temporal lobe foci. Epilepsia 1997;38(6):642–654CrossRefGoogle ScholarPubMed
Dolezalova, I, Brazdil, M, Hermanova, M, et al. Intracranial EEG seizure onset patterns in unilateral temporal lobe epilepsy and their relationship to other variables. Clin Neurophysiol 2013;124(6):1079–1088Google Scholar
Holtkamp, M, Sharan, A, Sperling, MR. Intracranial EEG in predicting surgical outcome in frontal lobe epilepsy. Epilepsia 2012;53(10):1739–1745CrossRefGoogle ScholarPubMed
Jenssen, S, Roberts, CM, Gracely, EJ, Dlugos, DJ, Sperling, MR. Focal seizure propagation in the intracranial EEG. Epilepsy Res 2011;93(1):25–32CrossRefGoogle ScholarPubMed
Goncharova, II, Spencer, SS, Duckrow, RB, et al. Intracranially recorded interictal spikes: relation to seizure onset area and effect of medication and time of day. Clin Neurophysiol 2013;124(11):2119–2128Google Scholar
Marsh, ED, Peltzer, B, Brown, MW, 3rd, et al. Interictal EEG spikes identify the region of electrographic seizure onset in some, but not all, pediatric epilepsy patients. Epilepsia 2010;51(4):592–601Google Scholar
Bourien, J, Bartolomei, F, Bellanger, JJ, et al. A method to identify reproducible subsets of co-activated structures during interictal spikes: application to intracerebral EEG in temporal lobe epilepsy. Clin Neurophysiol 2005;116(2):443–455Google Scholar
Engel, J, Jr, da Silva, FL. High-frequency oscillations – where we are and where we need to go. Prog Neurobiol 2012;98(3):316–318Google Scholar
Jacobs, J, Zijlmans, M, Zelmann, R, et al. High-frequency electroencephalographic oscillations correlate with outcome of epilepsy surgery. Ann Neurol 2010;67(2):209–220Google Scholar
Dumpelmann, M, Jacobs, J, Schulze-Bonhage, A. Temporal and spatial characteristics of high frequency oscillations as a new biomarker in epilepsy. Epilepsia 2015;56(2):197–206CrossRefGoogle ScholarPubMed
Jobst, BC, Engel, J, Jr. Is it time to replace epileptic spikes with fast ripples? Neurology 2015;85(2):114–115Google Scholar
Zangaladze, A, Sharan, A, Evans, J, et al. The effectiveness of low-frequency stimulation for mapping cortical function. Epilepsia 2008;49(3):481–487Google Scholar
Lesser, RP, Kim, SH, Beyderman, L, et al. Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation. Neurology 1999;53(9):2073–2081Google Scholar
Wheeler, M, De Herdt, V, Vonck, K, et al. Efficacy of vagus nerve stimulation for refractory epilepsy among patient subgroups: a re-analysis using the Engel classification. Seizure 2011;20(4):331–335CrossRefGoogle ScholarPubMed
Wiebe, S, Blume, WT, Girvin, JP, Eliasziw, M. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med 2001;345(5):311–318Google Scholar
Engel, J, Jr, McDermott, MP, Wiebe, S, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. J Am Med Assoc 2012;307(9):922–930Google Scholar
Bell, B, Lin, JJ, Seidenberg, M, Hermann, B. The neurobiology of cognitive disorders in temporal lobe epilepsy. Nat Rev Neurol 2011;7(3):154–164Google Scholar
Josephson, CB, Dykeman, J, Fiest, KM, et al. Systematic review and meta-analysis of standard vs selective temporal lobe epilepsy surgery. Neurology 2013;80(18):1669–1676CrossRefGoogle ScholarPubMed
Bujarski, KA, Hirashima, F, Roberts, DW, et al. Long-term seizure, cognitive, and psychiatric outcome following trans-middle temporal gyrus amygdalohippocampectomy and standard temporal lobectomy. J Neurosurg 2013;119(1):16–23Google Scholar
Helmstaedter, C. Cognitive outcomes of different surgical approaches in temporal lobe epilepsy. Epileptic Disord 2013;15(3):221–239Google Scholar
Englot, DJ, Wang, DD, Rolston, JD, et al. Rates and predictors of long-term seizure freedom after frontal lobe epilepsy surgery: a systematic review and meta-analysis. J Neurosurg 2012;116(5):1042–1048CrossRefGoogle ScholarPubMed
Hamid, H, Blackmon, K, Cong, X, et al. Mood, anxiety, and incomplete seizure control affect quality of life after epilepsy surgery. Neurology 2014;82(10):887–894Google Scholar
Early Randomized Surgical Epilepsy Trial (ERSET) Study Group, Engel, J, Jr, McDermott, MP, Wiebe, S, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. J Am Med Assoc 2012;307(9):922–930Google Scholar
Seiam, AH, Dhaliwal, H, Wiebe, S. Determinants of quality of life after epilepsy surgery: systematic review and evidence summary. Epilepsy Behav 2011;21(4):441–445Google Scholar
Birbeck, GL, Hays, RD, Cui, X, Vickrey, BG. Seizure reduction and quality of life improvements in people with epilepsy. Epilepsia 2002;43(5):535–538Google Scholar
Chin, PS, Berg, AT, Spencer, SS, et al. Employment outcomes following resective epilepsy surgery. Epilepsia 2007;48(12):2253–2257CrossRefGoogle ScholarPubMed
Hamiwka, L, Macrodimitris, S, Tellez-Zenteno, JF, et al. Social outcomes after temporal or extratemporal epilepsy surgery: a systematic review. Epilepsia 2011;52(5):870–879Google Scholar
Tellez-Zenteno, JF, Ronquillo, LH and Wiebe, S. Sudden unexpected death in epilepsy: evidence-based analysis of incidence and risk factors. Epilepsy Res 2005;65(1–2):101–115Google Scholar
Ryvlin, P, Montavont, A, Kahane, P. The impact of epilepsy surgery on mortality. Epileptic Disord 2005;7(Suppl 1):S39–S46Google ScholarPubMed
Hader, WJ, Tellez-Zenteno, J, Metcalfe, A, et al. Complications of epilepsy surgery: a systematic review of focal surgical resections and invasive EEG monitoring. Epilepsia 2013;54(5):840–847Google Scholar
Sherman, EM, Wiebe, S, Fay-McClymont, TB, et al. Neuropsychological outcomes after epilepsy surgery: systematic review and pooled estimates. Epilepsia 2011;52(5):857–869Google Scholar
Helmstaedter, C, Kurthen, M, Lux, S, Reuber, M, Elger, CE. Chronic epilepsy and cognition: a longitudinal study in temporal lobe epilepsy. Ann Neurol 2003;54(4):425–432Google Scholar
Rayner, G, Wrench, JM, Wilson, SJ. Differential contributions of objective memory and mood to subjective memory complaints in refractory focal epilepsy. Epilepsy Behav 2010;19(3):359–364Google Scholar
Wilson, SJ, Bladin, PF, Saling, MM, McIntosh, AM, Lawrence, JA. The longitudinal course of adjustment after seizure surgery. Seizure 2001;10(3):165–172Google Scholar
Cleary, RA, Baxendale, SA, Thompson, PJ, Foong, J. Predicting and preventing psychopathology following temporal lobe epilepsy surgery. Epilepsy Behav 2013;26(3):322–334Google Scholar
Jobst, BC, Williamson, PD, Thadani, VM, et al. Intractable occipital lobe epilepsy: clinical characteristics and surgical treatment. Epilepsia 2010;51(11):2334–2337Google Scholar
Zentner, J, Hufnagel, A, Pechstein, U, Wolf, HK, Schramm, J. Functional results after resective procedures involving the supplementary motor area. J Neurosurg 1996;85(4):542–549Google Scholar

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