Guía clínica. Evaluación prequirúrgica en epilepsia refractaria

Abstract

Epilepsy surgery is an approved treatment for the management of drug-resistant epilepsy. Approximately one third of patients with epilepsy present refractory epilepsy (RE). RE is considered a grave public health threat, carrying important bio-psy-cho-social consequences including accidents, professional limitations and increased risk of sudden death. Surgery is asso-ciated with seizure freedom in approximately 65% of patients after five years of follow-up. Patients with drug-resistant epilepsy should be referred to a specialized center for presurgical evaluation. Presurgical evaluation requires minimally detailed clinical analysis, electroencephalogram, video-electroencephalogram, magnetic resonance imaging, neuropsychological and developmental evaluation, and psychiatric evaluation. The most frequent surgical procedures are temporal lobe resections, followed by extratemporal and multilobar resections, lesionectomy, hemispherectomies, callosotomies and multiple subpial transections.