Biomaterial Database

Surgical resection of epileptogenic cortex associated with structural lesions. 1993

J P Weber, and D L Silbergeld, and H R Winn

Department of Neurosurgery, University of Washington School of Medicine, Seattle.

In this article we have reviewed the available data for postsurgical seizure control in patients with both structural lesions and seizures. There is evidence that simple excision alone will control seizures in some patients, whereas others require, in addition, seizure surgery with resection of epileptogenic cortex. When available studies are reviewed and submitted to meta-analysis, however, we have found that more patients are seizure free at 2-year follow-up after seizure surgery than after simple excision. Seizure control is one of the many factors that influence the choice of surgical approach. Therefore, we do not recommend that all patients with structural lesions and seizures disorders undergo seizure surgery. Rather, for those patients with a structural lesion in whom seizures are medically intractable, our review supports excision of the structural lesion as well as resection of the epileptogenic cortex to provide the patient with the best opportunity of seizure control.

UI	MeSH Term	Description	Entries
D002540	Cerebral Cortex	The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions.	Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D004827	Epilepsy	A disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns (e.g., nocturnal epilepsy). (From Adams et al., Principles of Neurology, 6th ed, p313)	Aura,Awakening Epilepsy,Seizure Disorder,Epilepsy, Cryptogenic,Auras,Cryptogenic Epilepsies,Cryptogenic Epilepsy,Epilepsies,Epilepsies, Cryptogenic,Epilepsy, Awakening,Seizure Disorders
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man