Temporal Lobectomy for Refractory Epilepsy

Epidemiologische Daten zum plötzlichen, unerklärbaren Tod bei Epilepsie

“…Sperling et al [46] Philadelphia/USA Epilepsiechirurgie, nichtanfallsfreie vs. anfallsfreie Patienten 7,5 vs. 0 c Hennessy et al [47] London/GB Epilepsiechirurgie 2,2 Nilsson et al [48] Schweden Epilepsiechirurgie, operierte und nicht operierte Patienten 2,4 (operiert)/ 6,3 (nicht operiert) Sperling et al [49] Philadelphia/USA Epilepsiechirurgie 6,7 Dasheiff [50] Pittsburgh/USA Epilepsiechirurgie 10 PJ Personenjahre, VNS Vagusnerv-Stimulation; a high probable SUDEP, b "definite/probable/possible", c bei den anfallsfreien Patienten war kein SUDEP aufgetreten; bezogen auf alle operierten Patienten war die Inzidenz 4 pro 1000 PJ A. Schulze-Bonhage in diesem Heft). Jedoch scheint das Mortalitätsrisiko nach Epilepsiechirurgie -auch bei erfolgreich operierten Patienten -im Vergleich zur Normalpopulation noch erhöht zu sein [52].…”

The current treatment of epilepsy: A challenge of choices

“…This section discusses the decision process of epilepsy surgery. The subject of various operative techniques and presurgical evaluations are dealt with in greater depth elsewhere [16][17][18][19]. However, Table 3 has been provided to serve as an overview of the most commonly performed surgeries for epilepsy and their indications.…”

“…However, others seem reasonably well adjusted and are productive members of society. A patient need not be dis- [19]. The presence of a psychiatric disorder is not necessarily a contraindication to surgery, but the surgical team should evaluate it.…”

Clinical neurophysiology of epilepsy

“…Brain surgery is recognized as a safe and effective treatment for refractory localization-related epilepsy [37,38]. In a recent randomized, controlled trial, temporal lobectomy was found to be superior to prolonged medical therapy in patients with intractable epilepsy; after 1 year, 58% of surgery patients were free of seizures impairing awareness compared with only 8% in the medical group [39•].…”