Controversies in Epilepsy Surgery

This book aims to provide the reader with an in-depth overview of the diagnostic and therapeutic options currently available in epilepsy surgery. It juxtaposes diagnostic methods and surgical techniques that have existed for a long time and others that have recently been developed or have gained importance. The nuanced comparison shows that several methods may be applicable for the same indication but, depending on the specific circumstances, one of them may be the best choice.

The book is divided into four main parts, focusing on anatomy, pre-surgical diagnostic evaluation of epilepsy, curative surgical treatment of epilepsy and symptomatic surgical treatment of epilepsy. The chapters are designed to describe not only a method or technique but also their specific risks or the limits where the competing option may become preferable.

The book thus guides the readers through the current controversies and helps them make a rational decision for their patients. It will be a valuable resource for neurosurgeons, neurologists, neurophysiologists, neuroradiologists and neuropsychologists dedicated to the treatment of drug-resistant epilepsy and for the multidisciplinary epilepsy surgery conferences.

Preface. - Part 1. - The Temporal Lobe and the Limbic System. - Anatomy of the Insula. - Anatomy of the Thalamus. - Part 2. - 3-Tesla MR Imaging for the Detection of Structural Lesions. - Clinical Applications of 7 Tesla Magnetic Resonance Imaging for Epilepsy. - Automated Detection of Structural Brain Lesions from MRI. - Ictal SPECT and its Value in the Localization of the Seizure-Onset Zone. - Interictal PET and its Value in the Localization of the Seizure-Onset Zone. - Neuropsychological Assessment of Cognition and Functional Reserve. - Functional Magnetic Resonance Imaging (fMRI) for the Evaluation of Cognition and Functional Reserve. - The Wada Test for the Evaluation of Cognition and Functional Reserve. - Electrical Source Imaging in the Presurgical Evaluation. - Magnetic Source Localization. - Indication and interpretation of SEEG. - Indication and Interpretation of Electrocorticography by Subdural and Spencer-Type Electrodes. - Frame-Based Implantation of Stereo EEG Electrodes. - Robot-Assisted Implantation of Stereo EEG Electrodes. - Frameless Implantation of Stereo EEG Electrodes. - Spatial Bayesian Approach to sEEG Electrode Placement. - Electrical Source Imaging Guidance of Depth Electrode Placement. - Intraoperative Electrocorticography. - Extraoperative Electrocorticography. Part 3. - Anterior Temporal Lobectomy for Temporal Lobe Epilepsy. - Selective Amygdalohippocampectomy. - Transsylvian approach to selective Amygdalohippocampectomy. - Subtemporal Approach for Amygdalohippocampectomy. - Selective Amygdalohippocampotomy using LITT. - Radiosurgery for mesial temporal lobe epilepsy. - Multiple Hippocampal Transection for Preservation of Verbal Memory. - Microsurgery and Endoscopic Surgery for Hypothalamic Hamartoma. - Radiosurgery for Hypothalamic Hamartoma. - LiTT Ablation for Hypothalamic Hamartoma. - Radiofrequency Ablation for Hypothalamic Hamartoma. - Stereo-electroencephalography guided RadioFrequency ThermoCoagulation for (sub)cortical epileptogenic lesions. - LiTT Ablation for Subcortical Epileptogenic Lesions. - Focused Ultrasound for Subcortical Epileptogenic Lesions. - Hemispherotomy through Vertical Approach. - Lateral Approach for Hemispherotomy. - Part 4. - The Evolution of Corpus Callosotomy: Theory and Practice. - Vagus Nerve Stimulation for the Management of Epilepsy and Epileptic Drop Attacks. - Radiofrequency ablation of the thalamic centrum medianum for catastrophic epilepsy. - Selective posterior callosotomy: An innovative approach targeted to disconnect fibers relevant to epileptic drop attacks. - Callosotomy by means of radiosurgery. - Subthalamic Nucleus as Deep Brain Stimulation Target in the Management of Epilepsy. - The Centromedian Thalamic Nucleus as a Deep Brain Stimulation Target in the Management of Epilepsy. - The Anterior Nucleus of Thalamus as a Deep Brain Stimulation Target in the Management of Epilepsy. - Open vs. Closed-Loop Stimulation in the Management of Drug-Resistant Epilepsy. - Extraventricular Approach for Deep Brain Stimulation of the Anterior Nucleus of Thalamus. - Transventricular Approach to Anterior Nucleus of Thalamus. - The Psychological Impact of Epilepsy Surgery.