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Semin Neurol 2008; 28(3): 355-363
DOI: 10.1055/s-2008-1079340
© Thieme Medical Publishers

Epilepsy Surgery and Vagal Nerve Stimulation: What All Neurologists Should Know

Antoaneta Balabanov1 , Marvin A. Rossi1
  • 1Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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Publication History

Publication Date:
24 July 2008 (online)

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ABSTRACT

Epilepsy surgery treatment should be considered as standard of care for all patients with medically intractable partial-onset epilepsy who are found to be good surgical candidates based on their presurgical evaluation. Delaying surgical treatment continues to be a problem among neurologists. The early recognition of pharmacoresistance and patients' referral for presurgical evaluation can shorten the time to identify potential surgical candidates. A successful early surgery can be expected to significantly improve these patients' quality of life, not only because of a seizure-free state but also by improving psychiatric comorbidities. Vagal nerve stimulation (VNS) is currently the only FDA-approved neurostimulation treatment strategy for patients who are not considered candidates for epilepsy surgery. VNS has been shown to decrease seizure frequency by approximately 50% in 30 to 40% of implanted patients. The future of epilepsy surgery and neurostimulation for those individuals with medically intractable partial-onset epilepsy shows great promise.

KEYWORDS

Intractable epilepsy - temporal lobe epilepsy - frontal lobe epilepsy - mesial temporal sclerosis - neurostimulation

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Antoaneta BalabanovM.D. 

Department of Neurological Sciences, Rush University Medical Center

1653 West Congress Parkway, Chicago, IL 60612

Email: Antoanetta_J_Balabanov@rush.edu