TITLE:
A Review of the Surgical Procedures for the Treatment of Drug-Resistant Epilepsy and Their Seizure Control Outcomes
AUTHORS:
Talal Salem, Cohen Chetty, Ochran Chetty
KEYWORDS:
Drug-Resistant Epilepsy, Vagus Nerve Stimulation, Seizure Control, Neurostimulation
JOURNAL NAME:
Surgical Science,
Vol.14 No.8,
August
16,
2023
ABSTRACT: Background: Drug-resistant epilepsy can be defined as the existence of seizures
within 6 months, despite adequate therapy regimens with one or more
antiepileptic drugs. Epilepsy surgery has been the standard therapy to help
those patients who suffer from drug-resistant epilepsy. The goal of this
surgery is to halt or reduce the intensity of seizures. This literature review
aims to provide an overview of existing surgical procedures for the treatment
of drug-resistant epilepsy and the degree of seizure control they provide based
on available literature. Methods: Data were collected from medical
journal databases, aggregators, and individual publications. The most used
databases were PubMed, Medline and NCBI. Some of the keywords used to search
these databases include: “drug resistant epilepsy”, “seizure control”, and “neurosurgery”. Results: Epileptic surgery is
divided into resective and non-resective procedures. Studies have shown that a full resection of the epileptogenic
brain area increases the probability of seizure eradication, however, the risks
of postoperative impairments grow as the resection area is extended. On
the other hand, patients who
are unsuitable for seizure focus removal by resective surgery, such as those
with multifocal seizures or overlapping epileptogenic zone with a functional
cortex, may benefit from non-resective surgical options such as Vagus Nerve Stimulation and Responsive
Neurostimulation. Conclusion: This literature review discusses the
comprehensive treatment of epilepsy, especially the surgical treatment of
drug-resistant epilepsy. The reviewed studies have shown that epilepsy surgery
has promising outcomes in achieving seizure freedom/reducing seizure frequency
with minimal adverse effects when performed correctly with the appropriate choice
of surgical candidates.