Epilepsi Cerrahisi Teknikleri
Özet
Epilepsi cerrahisinin amacı, nöbeti başlatan epileptojenik zonu çıkarmak veya diskonnekte etmektir. Ancak bunu yaparken temel sorun, bu epileptojenik zonun kesin olarak anatomik lokalizasyonunu tespit etmektir. En epileptojenik bölge olan temporal lob aynı zamanda yetişkinlerde en yaygın etiyolojik neden olan mezial temporal skleroz ile birlikte rezektif cerrahi için de en yaygın hedeftir. Anterior mezial temporal lobektomi, bu hastaların cerrahi tedavisi için en sık uygulanan prosedürdür. Çocuklarda ise epilepsi sıklıkla ekstemporal kaynaklıdır ve çoğunluğunu fokal kortikal displazi gibi gelişimsel beyin anormallikleri ve düşük dereceli kortikal tümörler oluşturur; saf mezial temporal lob epilepsisi ve mezial temporal skleroz ise daha az sıklıkta görülür. Hemisferik cerrahi teknikleri, tek taraflı multilobar veya hemisferik epilepsisi olan çocukların tedavisinde yüksek başarı oranlarına sahip son derece etkili cerrahi yöntemlerdir. Epilepsi cerrahisinde bir diğer yaklaşım ise palyatif cerrahidir ve korpus kallozotomi, vagal sinir stimülasyonu (VNS) ve diğer nöromodülasyon (derin beyin ve kortikal stimulasyon, responsif nörostimulasyon) işlemlerini içerir. Son yıllarda, minimal invazif yaklaşımların ve lazer teknolojisinin gelişimi, ilaca dirençli epilepsi hastaları için yeni cerrahi seçenekleri gündeme getirmiştir. Ancak cerrahi düşünülen vakalar giderek daha karmaşık ve teşhis ve tedavi edilmesi daha zor hale gelmektedir. Bu karar verme süreci, çok yönlü ve multidisipliner bir ekip yaklaşımını gerektirir.
Referanslar
Sinclair DB, Wheatley M, Aronyk K, et al. Pathology and neuroimaging in pediatric temporal lobectomy for intractable epilepsy. Pediatr Neurosurg. 2001;35(5):239-246.
Bourgeois M, Sainte-Rose C, Lellouch-Tubiana A, et al. Surgery of epilepsy associated with focal lesions in childhood. J Neurosurg. 1999;90(5):833-842.
Gunbey C, Soylemezoglu F, Bilginer B, et al. International consensus classification of hippocampal sclerosis and etiologic diversity in children with temporal lobectomy. Epilepsy Behav. 2020;112:107380.
Blume WT, Hwang PA. Pediatric candidates for temporal lobe epilepsy surgery. Can J Neurol Sci. 2000;27 Suppl 1:S14-19; discussion S20-11.
Bourgeois BF. Temporal lobe epilepsy in infants and children. Brain Dev. 1998;20(3):135-141.
Davies KG, Hermann BP, Dohan FC, Jr., Foley KT, Bush AJ, Wyler AR. Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients. Epilepsy Res. 1996;24(2):119-126.
Lewis DV. Febrile convulsions and mesial temporal sclerosis. Curr Opin Neurol. 1999;12(2):197-201.
Benifla M, Otsubo H, Ochi A, et al. Temporal lobe surgery for intractable epilepsy in children: an analysis of outcomes in 126 children. Neurosurgery. 2006;59(6):1203-1213; discussion 1213-1204.
Clusmann H, Kral T, Gleissner U, et al. Analysis of different types of resection for pediatric patients with temporal lobe epilepsy. Neurosurgery. 2004;54(4):847-859; discussion 859-860.
Feindel W, Leblanc R, de Almeida AN. Epilepsy surgery: historical highlights 1909-2009. Epilepsia. 2009;50 Suppl 3:131-151.
Spencer DD, Spencer SS, Mattson RH, Williamson PD, Novelly RA. Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy. Neurosurgery. 1984;15(5):667-671.
Adelson PD. Temporal lobectomy in children with intractable seizures. Pediatr Neurosurg. 2001;34(5):268-277.
Tanriverdi T, Olivier A, Poulin N, Andermann F, Dubeau F. Long-term seizure outcome after mesial temporal lobe epilepsy surgery: corticalamygdalohippocampectomy versus selective amygdalohippocampectomy. J Neurosurg. 2008;108(3):517-524.
Schramm J. Temporal lobe epilepsy surgery and the quest for optimal extent of resection: a review. Epilepsia. 2008;49(8):1296-1307.
Olivier A. Transcortical selective amygdalohippocampectomy in temporal lobe epilepsy. Can J Neurol Sci. 2000;27 Suppl 1:S68-76; discussion S92-66.
Park TS, Bourgeois BF, Silbergeld DL, Dodson WE. Subtemporal transparahippocampal amygdalohippocampectomy for surgical treatment of mesial temporal lobe epilepsy. Technical note. J Neurosurg. 1996;85(6):1172-1176.
Shimizu H, Suzuki I, Ishijima B. Zygomatic approach for resection of mesial temporal epileptic focus. Neurosurgery. 1989;25(5):798-801.
Ture U, Harput MV, Kaya AH, et al. The paramedian supracerebellar-transtentorial approach to the entire length of the mediobasal temporal region: an anatomical and clinical study. Laboratory investigation. J Neurosurg. 2012;116(4):773-791.
Wieser HG, Yasargil MG. Selective amygdalohippocampectomy as a surgical treatment of mesiobasal limbic epilepsy. Surg Neurol. 1982;17(6):445-457.
Yasargil MG, Krayenbuhl N, Roth P, Hsu SP, Yasargil DC. The selective amygdalohippocampectomy for intractable temporal limbic seizures. J Neurosurg. 2010;112(1):168-185.
Clusmann H, Kral T, Fackeldey E, et al. Lesional mesial temporal lobe epilepsy and limited resections: prognostic factors and outcome. J Neurol Neurosurg Psychiatry. 2004;75(11):1589-1596.
Bronen RA, Fulbright RK, Spencer DD, Spencer SS, Kim JH, Lange RC. MR characteristics of neoplasms and vascular malformations associated with epilepsy. Magn Reson Imaging. 1995;13(8):1153-1162.
Cataltepe O, Turanli G, Yalnizoglu D, Topcu M, Akalan N. Surgical management of temporal lobe tumor-related epilepsy in children. J Neurosurg. 2005;102(3 Suppl):280-287.
Pelliccia V, Deleo F, Gozzo F, et al. Early and late epilepsy surgery in focal epilepsies associated with long-term epilepsy-associated tumors. J Neurosurg. 2017;127(5):1147-1152.
Sevy A, Gavaret M, Trebuchon A, et al. Beyond the lesion: the epileptogenic networks around cavernous angiomas. Epilepsy Res. 2014;108(4):701-708.
Jehi LE, Palmini A, Aryal U, Coras R, Paglioli E. Cerebral cavernous malformations in the setting of focal epilepsies: pathological findings, clinical characteristics, and surgical treatment principles. Acta Neuropathol. 2014;128(1):55-65.
Cossu M, Raneri F, Casaceli G, Gozzo F, Pelliccia V, Lo Russo G. Surgical treatment of cavernoma-related epilepsy. J Neurosurg Sci. 2015;59(3):237-253.
Bartolomei JC, Christopher S, Vives K, Spencer DD, Piepmeier JM. Low-grade gliomas of chronic epilepsy: a distinct clinical and pathological entity. J Neurooncol. 1997;34(1):79-84.
Bilginer B, Yalnizoglu D, Soylemezoglu F, et al. Surgery for epilepsy in children with dysembryoplastic neuroepithelial tumor: clinical spectrum, seizure outcome, neuroradiology, and pathology. Childs Nerv Syst. 2009;25(4):485-491.
Drake J, Hoffman HJ, Kobayashi J, Hwang P, Becker LE. Surgical management of children with temporal lobe epilepsy and mass lesions. Neurosurgery. 1987;21(6):792-797.
Gunbey C, Bilginer B, Oguz KK, et al. Lesional resective epilepsy surgery in childhood: Comparison of two decades and long-term seizure outcome from a single center. Epilepsy Res. 2022;181:106882.
Tandon N, Esquenazi Y. Resection strategies in tumoral epilepsy: is a lesionectomy enough? Epilepsia. 2013;54 Suppl 9:72-78.
Harvey AS, Cross JH, Shinnar S, Mathern GW, Taskforce IPESS. Defining the spectrum of international practice in pediatric epilepsy surgery patients. Epilepsia. 2008;49(1):146-155.
Wyllie E, Comair YG, Kotagal P, Bulacio J, Bingaman W, Ruggieri P. Seizure outcome after epilepsy surgery in children and adolescents. Ann Neurol. 1998;44(5):740-748.
Paolicchi JM, Jayakar P, Dean P, et al. Predictors of outcome in pediatric epilepsy surgery. Neurology. 2000;54(3):642-647.
Liava A, Francione S, Tassi L, et al. Individually tailored extratemporal epilepsy surgery in children: anatomo-electro-clinical features and outcome predictors in a population of 53 cases. Epilepsy Behav. 2012;25(1):68-80.
Centeno RS, Yacubian EM, Sakamoto AC, Ferraz AF, Junior HC, Cavalheiro S. Pre-surgical evaluation and surgical treatment in children with extratemporal epilepsy. Childs Nerv Syst. 2006;22(8):945-959.
Spencer S, Huh L. Outcomes of epilepsy surgery in adults and children. Lancet Neurol. 2008;7(6):525-537.
De Ribaupierre S, Delalande O. Hemispherotomy and other disconnective techniques. Neurosurg Focus. 2008;25(3):E14.
Rasmussen T. Hemispherectomy for seizures revisited. Can J Neurol Sci. 1983;10(2):71-78.
Ignelzi RJ, Bucy PC. Cerebral hemidecortication in the treatment of infantile cerebral hemiatrophy. J Nerv Ment Dis. 1968;147(1):14-30.
Winston KR, Welch K, Adler JR, Erba G. Cerebral hemicorticectomy for epilepsy. J Neurosurg. 1992;77(6):889-895.
Sarkis RA, Jehi L, Najm IM, Kotagal P, Bingaman WE. Seizure outcomes following multilobar epilepsy surgery. Epilepsia. 2012;53(1):44-50.
Daniel RT, Meagher-Villemure K, Farmer JP, Andermann F, Villemure JG. Posterior quadrantic epilepsy surgery: technical variants, surgical anatomy, and case series. Epilepsia. 2007;48(8):1429-1437.
Turanli G, Yalnizoglu D, Genc-Acikgoz D, Akalan N, Topcu M. Outcome and long term follow-up after corpus callosotomy in childhood onset intractable epilepsy. Childs Nerv Syst. 2006;22(10):1322-1327.
Morrell F, Whisler WW, Bleck TP. Multiple subpial transection: a new approach to the surgical treatment of focal epilepsy. J Neurosurg. 1989;70(2):231-239.
Yalnizoglu D, Ardicli D, Bilginer B, et al. Long-term effects of vagus nerve stimulation in refractory pediatric epilepsy: A single-center experience. Epilepsy Behav. 2020;110:107147.
Jimenez AJ, Garcia-Verdugo JM, Gonzalez CA, et al. Disruption of the neurogenic niche in the subventricular zone of postnatal hydrocephalic hyh mice. J Neuropathol Exp Neurol. 2009;68(9):1006-1020.
Jobst BC, Kapur R, Barkley GL, et al. Brain-responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia. 2017;58(6):1005-1014.
Sun FT, Morrell MJ, Wharen RE, Jr. Responsive cortical stimulation for the treatment of epilepsy. Neurotherapeutics. 2008;5(1):68-74.
Kalina M, Lisck R, Vojtech Z, et al. Stereotactic amygdalohippocampectomy for temporal lobe epilepsy: promising results in 16 patients. Epileptic Disord. 2007;9 Suppl 1:S68-74.
Guenot M, Isnard J, Ryvlin P, Fischer C, Mauguiere F, Sindou M. SEEG-guided RF thermocoagulation of epileptic foci: feasibility, safety, and preliminary results. Epilepsia. 2004;45(11):1368-1374.
Tovar-Spinoza Z, Carter D, Ferrone D, Eksioglu Y, Huckins S. The use of MRI-guided laser-induced thermal ablation for epilepsy. Childs Nerv Syst. 2013;29(11):2089-2094.
Referanslar
Sinclair DB, Wheatley M, Aronyk K, et al. Pathology and neuroimaging in pediatric temporal lobectomy for intractable epilepsy. Pediatr Neurosurg. 2001;35(5):239-246.
Bourgeois M, Sainte-Rose C, Lellouch-Tubiana A, et al. Surgery of epilepsy associated with focal lesions in childhood. J Neurosurg. 1999;90(5):833-842.
Gunbey C, Soylemezoglu F, Bilginer B, et al. International consensus classification of hippocampal sclerosis and etiologic diversity in children with temporal lobectomy. Epilepsy Behav. 2020;112:107380.
Blume WT, Hwang PA. Pediatric candidates for temporal lobe epilepsy surgery. Can J Neurol Sci. 2000;27 Suppl 1:S14-19; discussion S20-11.
Bourgeois BF. Temporal lobe epilepsy in infants and children. Brain Dev. 1998;20(3):135-141.
Davies KG, Hermann BP, Dohan FC, Jr., Foley KT, Bush AJ, Wyler AR. Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients. Epilepsy Res. 1996;24(2):119-126.
Lewis DV. Febrile convulsions and mesial temporal sclerosis. Curr Opin Neurol. 1999;12(2):197-201.
Benifla M, Otsubo H, Ochi A, et al. Temporal lobe surgery for intractable epilepsy in children: an analysis of outcomes in 126 children. Neurosurgery. 2006;59(6):1203-1213; discussion 1213-1204.
Clusmann H, Kral T, Gleissner U, et al. Analysis of different types of resection for pediatric patients with temporal lobe epilepsy. Neurosurgery. 2004;54(4):847-859; discussion 859-860.
Feindel W, Leblanc R, de Almeida AN. Epilepsy surgery: historical highlights 1909-2009. Epilepsia. 2009;50 Suppl 3:131-151.
Spencer DD, Spencer SS, Mattson RH, Williamson PD, Novelly RA. Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy. Neurosurgery. 1984;15(5):667-671.
Adelson PD. Temporal lobectomy in children with intractable seizures. Pediatr Neurosurg. 2001;34(5):268-277.
Tanriverdi T, Olivier A, Poulin N, Andermann F, Dubeau F. Long-term seizure outcome after mesial temporal lobe epilepsy surgery: corticalamygdalohippocampectomy versus selective amygdalohippocampectomy. J Neurosurg. 2008;108(3):517-524.
Schramm J. Temporal lobe epilepsy surgery and the quest for optimal extent of resection: a review. Epilepsia. 2008;49(8):1296-1307.
Olivier A. Transcortical selective amygdalohippocampectomy in temporal lobe epilepsy. Can J Neurol Sci. 2000;27 Suppl 1:S68-76; discussion S92-66.
Park TS, Bourgeois BF, Silbergeld DL, Dodson WE. Subtemporal transparahippocampal amygdalohippocampectomy for surgical treatment of mesial temporal lobe epilepsy. Technical note. J Neurosurg. 1996;85(6):1172-1176.
Shimizu H, Suzuki I, Ishijima B. Zygomatic approach for resection of mesial temporal epileptic focus. Neurosurgery. 1989;25(5):798-801.
Ture U, Harput MV, Kaya AH, et al. The paramedian supracerebellar-transtentorial approach to the entire length of the mediobasal temporal region: an anatomical and clinical study. Laboratory investigation. J Neurosurg. 2012;116(4):773-791.
Wieser HG, Yasargil MG. Selective amygdalohippocampectomy as a surgical treatment of mesiobasal limbic epilepsy. Surg Neurol. 1982;17(6):445-457.
Yasargil MG, Krayenbuhl N, Roth P, Hsu SP, Yasargil DC. The selective amygdalohippocampectomy for intractable temporal limbic seizures. J Neurosurg. 2010;112(1):168-185.
Clusmann H, Kral T, Fackeldey E, et al. Lesional mesial temporal lobe epilepsy and limited resections: prognostic factors and outcome. J Neurol Neurosurg Psychiatry. 2004;75(11):1589-1596.
Bronen RA, Fulbright RK, Spencer DD, Spencer SS, Kim JH, Lange RC. MR characteristics of neoplasms and vascular malformations associated with epilepsy. Magn Reson Imaging. 1995;13(8):1153-1162.
Cataltepe O, Turanli G, Yalnizoglu D, Topcu M, Akalan N. Surgical management of temporal lobe tumor-related epilepsy in children. J Neurosurg. 2005;102(3 Suppl):280-287.
Pelliccia V, Deleo F, Gozzo F, et al. Early and late epilepsy surgery in focal epilepsies associated with long-term epilepsy-associated tumors. J Neurosurg. 2017;127(5):1147-1152.
Sevy A, Gavaret M, Trebuchon A, et al. Beyond the lesion: the epileptogenic networks around cavernous angiomas. Epilepsy Res. 2014;108(4):701-708.
Jehi LE, Palmini A, Aryal U, Coras R, Paglioli E. Cerebral cavernous malformations in the setting of focal epilepsies: pathological findings, clinical characteristics, and surgical treatment principles. Acta Neuropathol. 2014;128(1):55-65.
Cossu M, Raneri F, Casaceli G, Gozzo F, Pelliccia V, Lo Russo G. Surgical treatment of cavernoma-related epilepsy. J Neurosurg Sci. 2015;59(3):237-253.
Bartolomei JC, Christopher S, Vives K, Spencer DD, Piepmeier JM. Low-grade gliomas of chronic epilepsy: a distinct clinical and pathological entity. J Neurooncol. 1997;34(1):79-84.
Bilginer B, Yalnizoglu D, Soylemezoglu F, et al. Surgery for epilepsy in children with dysembryoplastic neuroepithelial tumor: clinical spectrum, seizure outcome, neuroradiology, and pathology. Childs Nerv Syst. 2009;25(4):485-491.
Drake J, Hoffman HJ, Kobayashi J, Hwang P, Becker LE. Surgical management of children with temporal lobe epilepsy and mass lesions. Neurosurgery. 1987;21(6):792-797.
Gunbey C, Bilginer B, Oguz KK, et al. Lesional resective epilepsy surgery in childhood: Comparison of two decades and long-term seizure outcome from a single center. Epilepsy Res. 2022;181:106882.
Tandon N, Esquenazi Y. Resection strategies in tumoral epilepsy: is a lesionectomy enough? Epilepsia. 2013;54 Suppl 9:72-78.
Harvey AS, Cross JH, Shinnar S, Mathern GW, Taskforce IPESS. Defining the spectrum of international practice in pediatric epilepsy surgery patients. Epilepsia. 2008;49(1):146-155.
Wyllie E, Comair YG, Kotagal P, Bulacio J, Bingaman W, Ruggieri P. Seizure outcome after epilepsy surgery in children and adolescents. Ann Neurol. 1998;44(5):740-748.
Paolicchi JM, Jayakar P, Dean P, et al. Predictors of outcome in pediatric epilepsy surgery. Neurology. 2000;54(3):642-647.
Liava A, Francione S, Tassi L, et al. Individually tailored extratemporal epilepsy surgery in children: anatomo-electro-clinical features and outcome predictors in a population of 53 cases. Epilepsy Behav. 2012;25(1):68-80.
Centeno RS, Yacubian EM, Sakamoto AC, Ferraz AF, Junior HC, Cavalheiro S. Pre-surgical evaluation and surgical treatment in children with extratemporal epilepsy. Childs Nerv Syst. 2006;22(8):945-959.
Spencer S, Huh L. Outcomes of epilepsy surgery in adults and children. Lancet Neurol. 2008;7(6):525-537.
De Ribaupierre S, Delalande O. Hemispherotomy and other disconnective techniques. Neurosurg Focus. 2008;25(3):E14.
Rasmussen T. Hemispherectomy for seizures revisited. Can J Neurol Sci. 1983;10(2):71-78.
Ignelzi RJ, Bucy PC. Cerebral hemidecortication in the treatment of infantile cerebral hemiatrophy. J Nerv Ment Dis. 1968;147(1):14-30.
Winston KR, Welch K, Adler JR, Erba G. Cerebral hemicorticectomy for epilepsy. J Neurosurg. 1992;77(6):889-895.
Sarkis RA, Jehi L, Najm IM, Kotagal P, Bingaman WE. Seizure outcomes following multilobar epilepsy surgery. Epilepsia. 2012;53(1):44-50.
Daniel RT, Meagher-Villemure K, Farmer JP, Andermann F, Villemure JG. Posterior quadrantic epilepsy surgery: technical variants, surgical anatomy, and case series. Epilepsia. 2007;48(8):1429-1437.
Turanli G, Yalnizoglu D, Genc-Acikgoz D, Akalan N, Topcu M. Outcome and long term follow-up after corpus callosotomy in childhood onset intractable epilepsy. Childs Nerv Syst. 2006;22(10):1322-1327.
Morrell F, Whisler WW, Bleck TP. Multiple subpial transection: a new approach to the surgical treatment of focal epilepsy. J Neurosurg. 1989;70(2):231-239.
Yalnizoglu D, Ardicli D, Bilginer B, et al. Long-term effects of vagus nerve stimulation in refractory pediatric epilepsy: A single-center experience. Epilepsy Behav. 2020;110:107147.
Jimenez AJ, Garcia-Verdugo JM, Gonzalez CA, et al. Disruption of the neurogenic niche in the subventricular zone of postnatal hydrocephalic hyh mice. J Neuropathol Exp Neurol. 2009;68(9):1006-1020.
Jobst BC, Kapur R, Barkley GL, et al. Brain-responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia. 2017;58(6):1005-1014.
Sun FT, Morrell MJ, Wharen RE, Jr. Responsive cortical stimulation for the treatment of epilepsy. Neurotherapeutics. 2008;5(1):68-74.
Kalina M, Lisck R, Vojtech Z, et al. Stereotactic amygdalohippocampectomy for temporal lobe epilepsy: promising results in 16 patients. Epileptic Disord. 2007;9 Suppl 1:S68-74.
Guenot M, Isnard J, Ryvlin P, Fischer C, Mauguiere F, Sindou M. SEEG-guided RF thermocoagulation of epileptic foci: feasibility, safety, and preliminary results. Epilepsia. 2004;45(11):1368-1374.
Tovar-Spinoza Z, Carter D, Ferrone D, Eksioglu Y, Huckins S. The use of MRI-guided laser-induced thermal ablation for epilepsy. Childs Nerv Syst. 2013;29(11):2089-2094.
