U centru epilepsije - povodom proslave 90-godišnjice Neurološke klinike u Beogradu

Abstract

The most important and simplest form of epilepsy treatment is the application of antiepileptic drugs. Its goal is to prevent the recurrence of epileptic attacks without provoking significant side effects. Unfortunately, in about 20-30% of patients antiepileptic drugs does not achieve seizure control. In a number of patients with pharmacoresistant focal epilepsy resective brain surgery is the optimal treatment method. Our experience as well as of the other epilepsy centers indicates that appropriate methods of preoperative evaluation and advanced techniques in epilepsy surgery are effective and safe methods of treatment resistant epilepsy, particularly temporal lobe epilepsy. Surgical treatment of pharmacoresistant focal epilepsy leads to full control of seizures in about 2/3 of the operated patients. In order to achieve the complete surgical success, it is necessary to remove or disconnect that area or part of the brain, which is responsible for the initiation of epileptic seizures. That part of the brain (i.e. cerebral cortex) is called the epileptogenic zone and should be removed with the maximum refrain from those parts of the brain responsible for an important function (i.e."eloquent" cortex). Different modalities of diagnostic tests that are now used as part of presurgical evaluation (video-EEG telemetry, magnetic resonance imaging, neuropsychological testing, functional neuroradiology), allow the precise localization of the epileptogenic zone in majority of patients.