Transcript
Page 1: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Epilepsy surgery

Page 2: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

History

Page 3: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 4: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 5: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 6: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 7: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 8: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 9: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 10: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 11: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 12: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 13: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Definition

• Seizure

• Convulsion

• Epilepsy

Page 14: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Epidemiology

• Prevalence : 52,000,000 around the world

• 700,000 in Iran

Page 15: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 16: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Pathophysiology

• Developmental pathology of brain

• Neuronal and glial disorders

• Kindling phenomenon

• Reorganization of cortical tissue in response to hypoxia

Page 17: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Kindling phenomenon

Page 18: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Treatment

• Standard : monotherapy by antiepileptic drugs

• Traditional : phenobarbital , phenytoin , primidone , carbamazepine , valproic acid

• New : lamotrigine , topiramate , levatiracetam ,…

Page 19: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Failure of medical therapy

• Misdiagnosis • Irregular follow up• Irregularity in treatment• Life style factors• Brain tumors• Sever traumatic brain injury

Page 20: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Refractory epilepsy

•30 % of patients

Page 21: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Causes of refractory epilepsy

• Temporal lob epilepsy : the most common• Neuronal structural disorders • Inflammatory disorders• Autoimmune mechanisms • Tumors and sever traumatic brain injuries

Page 22: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Temporal lobectomy and lesionectomy

Page 23: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 24: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 25: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 26: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 27: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 28: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 29: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 30: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 31: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 32: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 33: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 34: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 35: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 36: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 37: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 38: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 39: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 40: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Callosotomy

Page 41: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 42: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 43: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 44: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 45: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 46: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 47: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 48: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Indications

• Tuberos sclerosis

• Infantile spasm

• Lenox – Gustaut syndrome

Page 49: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 50: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Hemispher - ectomy , tomy

Page 51: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Rasmussen's encephalitis

Page 52: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 53: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 54: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Multiple subpial transection

Page 55: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 56: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 57: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Vagal nerve stimulation

Page 58: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Mechanism

• Nor epinephrine

• GABA

• Reticular activating system

Page 59: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 60: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy
Page 61: Epilepsy surgery. History Definition Seizure Convulsion Epilepsy

Top Related