Epilepsia extratemporal. Aspectos clínicos, diagnósticos y de tratamiento

Abstract

Partial seizures of extratemporal origin may present unique challenges in the patient with medically refractory seizures. Extratemporal focal cortical resections may be less effective than anterior temporal lobectomy for intractable epilepsy. Surgical complications may be increased in individuals with extratemporal epilepsy because eloquent cortex may involved, and larger cortical resections may be needed to significantly reduce epileptogenicity. 30-40% of patients with newly diagnosed epilepsy will develop medically refractory seizure disorders. The most effective treatment for intractable partial epilepsy is a focal cortical resection with excision of the epileptogenic zone, i.e., area of ictal onset and initial seizure propagation. The preoperative evaluation and surgical strategy in patients with partial epilepsy of extratemporal origin associated with pharmacoresistant seizures is determined by the anatomical localization of the epileptogenic zone and the presence of a lesion-related epilepsy. Prior to surgical treatment patients with extratemporal epilepsy will require a comprehensive preoperative evaluation including routine EEG, long-term EEG monitoring, neuropsychological studies, and magnetic resonance imaging.