Epilepsy Surgery

dr. Kevin Gunawan SpBS

Epilepsy Surgery
Introduction

Prevalence of 0.8 to 1.2%  one

of the most frequent chronic
neurological disorders

30 to 40% of patients suffer from

drug-resistant epilepsy

Epilepsy surgery represents a

valuable treatment option for 10
to 50% of these patients
 Epilepsy Surgery
Introduction

Pathological Findings

Hippocampal sclerosis (36.4%) Tumors (23,6%) Cortical Malformation Unknown Histopathologic

(19,8%) (7,7%)
Epilepsy Surgery
Introduction

Epilepsy surgery is indicated for patients with ‘drug-resistant’ epilepsy

failure of seizure control after

adequate medical therapy with
two or more appropriate anti-
epileptic drugs
 Epilepsy Surgery
Aim

Control Seizures  Resection

of epileptogenic tissue

Avoiding neuropsychological
and other neurological deficits
 Sparing essential brain
areas
Epilepsy Surgery
Pre Surgical Evaluation
 Epilepsy Surgery
Surgical Techniques

Lesion-Directed Stereotactic Radiosurgery

MR-guided laser SEEG-guided RFTC
Resection - Pooled Seizure Free Rate interstitial thermal - Pooled Seizure Free Rate
- Epilepsy surgeries 50,9% (Heterogenity 0- therapy 23%
requiring an 86%) - hypothalamic - safe treatment when
operculoinsulectomy - Effective to control conventional resective
hamartomas  93% were
pose significant seizures with better surgery is not feasible
free of gelastic seizures at
difficulties
neurophysiological one year
outcomes
Terima Kasih