The surgical treatment of intractable epilepsy.

The author reviewed the various surgical approaches for intractable epilepsy and proposes that any surgical operation for the treatment of intractable epilepsy be performed actively but prudently. It is important to identify the operation indication and to use combinations of anterior callosotomy, epileptogenic focus resection and multiple subpial transection (MST), tailored to the individual patient. Selective temporal lobe removal can also provide a fairly good result in temporal lobe seizures. For epileptogenic foci in functional areas, MST was an effective approach that protected neural function and blocked epileptic discharge. For epileptogenic foci in the free-functional areas, however, epileptogenic focus resection was still the best therapy. Hemisphere removal should be chosen cautiously and only for patients with intractable epilepsy with progressive neurological deficits in the hemisphere. The author notes that using minimally invasive neurosurgery techniques to treat epilepsy and to protect neural function will become more widely recommended. Copyright (C) 2001 S, Karger AG, Basel.