Complicated epilepsy surgery: importance of balancing benefit and deficit.

Autor:	Duncan JS; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, UCL, London, UK j.duncan@ucl.ac.uk., Beech V; Middlesbrough, UK., Chowdhury FA; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, UCL, London, UK.; Neurology, National Hospital for Neurology and Neurosurgery, London, UK., Miserocchi A; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, UCL, London, UK.; Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK., McEvoy A; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, UCL, London, UK.; Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
Jazyk:	angličtina
Zdroj:	Practical neurology [Pract Neurol] 2024 Sep 13; Vol. 24 (5), pp. 393-399. Date of Electronic Publication: 2024 Sep 13.
DOI:	10.1136/pn-2023-003901
Abstrakt:	The risk-benefit ratio of epilepsy surgery needs careful consideration, is different for each individual and requires a careful, informed dialogue between the person concerned and their medical advisers. We illustrate this process with Virginia, who has had refractory focal epilepsy from age 1 year and a left hemiparesis. At the age of 45 years, we discussed the possibility of epilepsy surgery and went through non-invasive investigations with structural and functional MRI, tractography, scalp video-EEG telemetry, neuropsychological and neuropsychiatric evaluations. This was followed by a decision to carry out intracranial EEG to define the area of seizure onset and its relation to an area of focal cortical dysplasia, eloquent cortex and tracts. We agreed to carry out a focal resection in the knowledge that this would result in a loss of left-hand function. One year later, Virginia is seizure-free on reduced medication. We describe the steps in the process with Virginia's views. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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