| Abstrakt: |
Macewen [1] and Horsley [2] are frequently considered to be the forerunners of modern epilepsy surgery. One could say that Horsley integrated Hughling Jackson's achievements into surgical action [3]. Foerster [4] and Krause and Schum [5] were the pioneers in epilepsy surgery in Germany, providing remarkable results emphasizing the importance of the excision of the ˵primary convulsing center,″ that is, the ˵discharging lesion.″ At that time, the ˵primary convulsing center″ was basically defined by the macroscopic location of the cortical lesion and by clinical ictal semiology. In the 1950s, Bailey and Gibbs [6] and the Montreal pioneers Penfield and Jasper [7]; Penfield and Jasper [23] were the first to use electroencephalographic recordings in order to plan and perform epilepsy surgery. The advance of stereo-electroencephalography, established in St. Anne, Paris, by Talairach [8] and Bancaud [9], has contributed enormously to our understanding of the origin and spread of seizure discharges, thus revolutionizing the concept of the primary epileptogenic zone. Today, many authors proffer a more pragmatic definition to determine the extent of resection. A simplified definition of the epileptogenic zone is ˵the minimum amount of cortex that must be resected, inactivated or completely disconnected in order to produce seizure-freedom.″ The concept of the primary epileptogenic zone will be discussed below in greater detail. [ABSTRACT FROM AUTHOR] |
