TAILIEUCHUNG - EPILEPSY: GLOBAL ISSUES FOR THE PRACTICING NEUROLOGIST- part 8

Bên cạnh đó là tỷ trọng lớn nhất của phẫu thuật khắc phục epilepsies, các hội chứng này có lợi thế bổ sung không được quá đòi hỏi về yêu cầu công nghệ. Nhiều ứng cử viên cho phẫu thuật thùy thái dương có thể trải qua phẫu thuật với kết quả xuất sắc trên cơ sở | EPILEPSY GLOBAL ISSUES FOR THE PRACTICING NEUROLOGIST KEYPOINTS Thus the challenge for specialized epileptologists in these countries is to develop realistic protocols and to continuously reevaluate surgical results in order to improve presurgical and operative approaches. al epilepsies. Besides constituting the largest proportion of surgically remediable epilepsies these syndromes have the additional advantage of not being too demanding in terms of technological requirements. Many candidates for temporal lobe surgery can undergo surgery with excellent results on the basis of interictal EEG epileptiform abnormalities neuropsychologic assessment and MRI. When evidence of hippocampal sclerosis is present and the other data are concordant for the same anterobasal temporal lobe region surgery is usually successful irrespective of the data provided by scalp ictal EEG. Presurgical evaluation without ictal EEG recordings however will demand even greater experience on the part of the diagnostic team which is why skilled personnel are the most essential component of an epilepsy surgery center where resources are limited. A 16-channel EEG machine with a video recorder plus a MRI and very good neuropsychology is all that is required to operate on many surgical candidates with mesial temporal lobe epilepsy as well as certain types of neocortical lesional epilepsies and surgically remediable catastrophic epilepsies of infancy and early childhood . Thus the challenge for specialized epileptol-ogists in these countries is to develop realistic protocols and to continuously re-evaluate surgical results in order to improve presurgi-cal and operative approaches. A valid question in this era of everincreasing high-technology approaches to diagnosis and treatment is whether minimum requirements for epilepsy surgery are changing. The answer is probably not. Technological progress allows patients with more complex epilepsy to be adequately evaluated and occasionally operated on in .

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