Recent advances in epilepsy surgery

Abstract

Purpose of reviewTechnological innovations in the preoperative evaluation, surgical techniques and outcome prediction in epilepsy surgery have grown exponentially over the last decade. This review highlights and emphasizes relevant updates in techniques and diagnostic tools, discussing their context within standard practice at comprehensive epilepsy centres. Recent findingsHigh-resolution structural imaging has set an unprecedented opportunity to detect previously unrecognized subtle abnormalities. Machine learning and computer science are impacting the methodologies to analyse presurgical and surgical outcome data, building more accurate prediction models to tailor treatment strategies. Robotic-assisted placement of depth electrodes has increased the safety and ability to sample epileptogenic nodes within deep structures, improving our understanding of the seizure networks in drugresistant epilepsy. The current available minimally invasive techniques are reasonable surgical alternatives to ablate or disrupt epileptogenic regions, although their sustained efficacy is still an active area of research.

High‐Resolution Recording of Neural Activity in Epilepsy Using Flexible Neural Probes

“…[8] Over the past few decades, implantable neural probes, such as stereo-electroencephalography (SEEG) and micro-wire probes, have contributed significantly to our understanding of epilepsy and the development of treatment strategies. [9][10][11][12] They have enabled localization of seizure onset zones, providing valuable data for the optimization of surgical interventions, and the design of closed-loop neurostimulation devices, as well as facilitated the identification of neural circuits involved in seizure generation for fundamental researches. [13] However, these conventional probes exhibit limitations in both their number of recording sites and mechanical properties.…”