Extratemporal Refractory Epilepsy

Abstract

Medically refractory epilepsy is defined as the persistence of seizures after appropriate treatment with 2 different medications. A thorough understanding of the clinical history and semiology of seizures is important when considering surgical treatment options, as multifocal epilepsy may not be amenable to resective surgery. Anatomic, functional, and metabolic imaging sequences may assist in identifying a seizure focus, and EEG will provide a functional localization. The surgeon must make a careful and informed decision about the maximal amount of lesion that may be resected without incurring neurologic deficits. Specific postoperative management should be dictated by the natural history of the noted pathology.