Abstract
Resective epilepsy surgery is an elective therapy indicated in focal epilepsy patients who are resistant to pharmacotherapy. Every effort should be undertaken to perform the procedures as safe and less traumatic as possible. Neuronavigation could represent a suitable tool to reduce surgical morbidity and increase surgical radicality. Here, we present a series of 41 patients who were operated on for medically intractable epilepsy using neuronavigation. Overall, complication rate was 17% with a favourable seizure outcome of 88% (Engel’s class I/II). Our data suggest that neuronavigation is a valuable surgical technique to accomplish a favourable outcome in epilepsy surgery.
Highlights
INTRODUCTIONPatients with focal epilepsy are generally surgical candidates, if medical treatment with at least two different anticonvulsive drugs in sufficient doses fails and disabling seizures persist
Regarding navigation accuracy we have clearly to distinguish between technical accuracy of the navigation system, registration accuracy and application accuracy depending of the intraoperative situation including brain shift [18]
We reviewed our surgical cases that were performed for pharmacoresistent focal epilepsy using a neuronavigation device
Summary
Patients with focal epilepsy are generally surgical candidates, if medical treatment with at least two different anticonvulsive drugs in sufficient doses fails and disabling seizures persist. From the technical point of view we can distinguish between armbased and armless navigation The latter have the advantage not to restrict the operative field. Regarding navigation accuracy we have clearly to distinguish between technical accuracy of the navigation system (how accurately the system determines the position in the 3-Dspace), registration accuracy (how accurately is the data transfer from 3-D-space into the CT and MRI image space) and application accuracy depending of the intraoperative situation including brain shift [18]. We reviewed our surgical cases that were performed for pharmacoresistent focal epilepsy using a neuronavigation device
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