Focal epilepsy surgery [Neurosurgery Wiki]

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====== Focal epilepsy surgery ======

[[Resection]] surgery is based on a pathological substrate identified as the cause of the seizure and is associated with the cure or control of focal seizures
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Epilepsy surgery reduced seizure activity in randomized clinical trials when compared with continued medical therapy. Long-term cognitive, psychiatric, psychosocial, and quality-of-life outcomes were less well defined. Despite good outcomes from high-quality clinical trials, referrals of patients with seizures refractory to medical treatment remain infrequent
((Jobst BC, Cascino GD. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. JAMA. 2015 Jan 20;313(3):285-93. doi: 10.1001/jama.2014.17426. PMID: 25602999.)).

===== Deep brain stimulation =====

[[Deep brain stimulation for focal epilepsy]].

===== Epicranial stimulation device =====
[[Epicranial stimulation device]]



===== VNS =====

[[VNS]] is approved for the treatment of focal epilepsy when surgery is not possible or does not work. A small electrical generator is implanted under the skin over the chest. A wire, called a “stimulator lead,” is then attached onto the vagus nerve located in the neck. The generator stimulates the vagus nerve on a set schedule. Over time this helps to reduce the number and severity of seizures a person has. It is effective in over half the people who try it.

===== Magnetic resonance image-guided laser interstitial thermal therapy =====
see [[Magnetic resonance image-guided laser interstitial thermal therapy for epilepsy]] ([[LITT]])