Question

Types of epilepsy surgery. [5]

Hint:

Epilepsy surgery can offer significant seizure relief in carefully selected patients. It is typically considered after a thorough evaluation of the seizure focus and failure of drug therapy.

Answer 1

Epilepsy surgery is considered for patients with drug-resistant epilepsy when seizures cannot be controlled with medications. Several types of surgical options are available.
Step 1: Resective Surgery:
1. Focal Cortical Resection: In this procedure, the area of the brain responsible for seizures (the epileptogenic zone) is surgically removed. This is typically performed in patients with a single, well-localized focus of seizures.
2. Hemispherectomy: In cases of severe, widespread epilepsy that affects one hemisphere of the brain, hemispherectomy involves the removal of part or all of one hemisphere to stop seizures.
Step 2: Disconnective Surgery:
1. Corpus Callosotomy: This procedure involves cutting the corpus callosum, which connects the two hemispheres of the brain, in order to limit the spread of seizure activity. This is often performed in patients with generalized seizures.
2. Multiple Subpial Transection: This technique involves making small cuts in the brain tissue to interrupt the spread of seizure activity without removing brain tissue.
Step 3: Laser Ablation:
1. Laser Interstitial Thermal Therapy (LITT): This minimally invasive technique uses a laser to ablate the seizure focus through a small incision. It is used in cases where resection is not feasible.