University of Washington Regional Epilepsy Center at Harborview Medical Center

Table of Contents

Epilepsy Surgery: Principles and Controversies

PART I. Who is a Surgical Candidate?

Section I. Determining Pharmacological Intractability--Rajiv Mohanraj and Martin J Brodie

CH 1. Definition of intractability is a function of epilepsy syndrome--F. Semah

CH 2. The role of new antiepileptic medications in determination of intractability.

2a. Trials of new antiepileptic medications are needed to demonstrate intractability--Tracy A. Glauser, M.D.

2b. The development of new medications has not substantially affected intractability--Michael D. Privitera and David M. Ficker

CH 3. Intractability in children and the role of the ketogenic diet

3a. When to Consider Children with Seizures for Surgery: Intractability and the role of the ketogenic diet--John M. Freeman

3b. Intractability, operability, and the role of the ketogenic diet--Blaise F.D. Bourgeois

Section II. Surgically Remedial Epilepsy Syndromes in Adults--Ednea A. Simon, Michael Doherty and John W. Miller

CH 4. The anatomy and pathophysiology of mesial temporal epilepsy

4a. Is mesial temporal sclerosis caused by early childhood neurological insults?--S. R. Haut. and S. L. Moshe

4b. The role of the hippocampus in mesial temporal lobe epilepsy: historical perspective--Thomas Babb

4c. The epileptic focus in mesial temporal epilepsy is in both the hippocampus and the entorhinal cortex--Nicholas P. Poolos

4d. Extrahippocampal regions are important in generation of mesial temporal lobe seizures--Uwe Heinemann and Thomas-Nicolas Lehmann

CH 5. What is the role of surgery in MRI-normal temporal lobe epilepsy?

5a. MRI normal mesial temporal epilepsy is a common, surgically remedial condition--George A Ojemann

5b. MRI-normal medial temporal lobe epilepsy has a less favorable surgical outcome--Aaron A. Cohen-Gadol, and Dennis D. Spencer

CH 6. What is the significance of dysplasia associated with mesial temporal sclerosis?

6a. Dysplasia associated with mesial temporal lobe sclerosis is common finding related to epileptogenesis.--Maria Thom

6b. Increased white matter neurons in temporal lobe epilepsy: An epiphenomenon--Steven N. Roper and Anthony T. Yachnis

Section III. Surgically treatable epilepsy syndromes in infancy and childhood--Russell P. Saneto and Elaine Wyllie

CH 7. The place of early surgical intervention in children.

7a. What are the arguments in favor of early surgical intervention in children?--Blaise F.D. Bourgeois

7b. Cognitive and Psychosocial Benefits of Early Surgical Intervention: What do we know?--Michael Westerveld,

7c. Epilepsy has significant effects on social and educational development: Implications for surgical decisions.--Matti Sillanpää

CH 8. What are the roles of medical and surgical management in Rasmussen's encephalitis?

8a. The role of early surgery in Rasmussen's Syndrome.--John M. Freeman

8b. Immunotherapy for Rasmussen's Encephalitis--John W. Gibbs, III and James O. McNamara

CH 9. The role of neurosurgery for the Landau-Kleffner syndrome.

9a. Landau-Kleffner Syndrome: A review--Michael C. Smith

9b. The role of surgery in Landau-Kleffner syndrome--Josiane LaJoie and Orrin Devinsky

9c. Epilepsy surgery is not useful for the Landau-Kleffner syndrome--Melissa J. Cline and Richard G. Ellenbogen

PART II. The Presurgical Workup

Section IV. Integrative Neuropsychology in the Preoperative Workup of the Epilepsy Surgery Patient--Rebecca Rausch

CH 10. Use of neuropsychological testing to locate the epileptogenic zone.

10a. Is neuropsychological testing a useful predictor of the epileptogenic zone? Review of the literature--Carl B. Dodrill

10b. Neuropsychological testing is a useful predictor of the epileptogenic zone--Elizabeth S. Stroup, and Elisabeth M.S. Sherman

10c. Neuropsychological testing is of limited value for predicting the epileptogenic zone--Sara J Swanson,

CH 11. Is the Wada test a useful predictor of memory outcome?

11a. Review of the Role of the Intracarotid Amobarbital Procedure (IAP) in Memory Assessment and Predicting Memory Outcome Following Anterior Temporal Lobectomy--Cynthia S. Kubu

11b. The Wada test is a useful predictor of memory outcome--David W. Loring and Kimford J. Meador

11c. The Wada test is not a useful predictor of material-specific memory change following temporal lobe surgery for epilepsy--Carl B. Dodrill

CH 12. When is the Wada test necessary for temporal lobectomy?

12a. The Wada test is needed for temporal lobectomies--Daniel Drane

12b. The Wada test may not always be needed prior to mesial temporal resection.--Jennifer Goldstein. and Frank Gilliam

Section V. Neurophysiological Studies in the Epilepsy Presurgical Evaluation--Mark D. Holmes

CH 13. Sphenoidal electrodes

13a. Sphenoidal electrodes should be used in presurgical evaluations of patients with temporal lobe epilepsy--Andres M. Kanner

13b. Sphenoidal electrodes have limited value--Colin D. Binnie

CH 14. The role of depth and subdural electrodes in the work-up of surgical candidates--Allen R. Wyler

CH 15. The role of noninvasive video EEG monitoring:

15a. Ictal monitoring is not needed in all temporal resections for mesial temporal sclerosis--Mona Sazgar and Gregory D. Cascino

15b. Ictal electroencephalographic monitoring should be performed before temporal resection--Thomas R. Henry

CH 16. Ictal semiology and the presurgical workup

16a. Ictal semiology is very useful for lateralizing seizures in the presurgical workup--Deepak K. Lachhwani and Prakash Kotagal

16b Limitations of ictal semiology for lateralizing seizures Andrea Cheng-Hakimian, and Alan J. Wilensky

Section VI. MRI Evaluation in Epilepsy and in the Epilepsy Presurgical Evaluation--Danial K. Hallam

CH 17. Will fMRI replace the Wada test?

17a. Review of assessment of temporal lobe function with fMRI-Jeffrey G. Ojemann

17b. FMRI could in principle replace the Wada test--J. R. Binder

17c. FMRI is not a replacement for the Wada test--M.R. Trenerry

CH 18. The role of MRS in the Evaluation of Patients for Epilepsy Surgery--Susanne G. Mueller and Kenneth D. Laxer

Section VII. Radiotracer Studies in the Epilepsy Presurgical Evaluation

CH 19. Overview of PET in epilepsy and epilepsy surgery--Cynthia Mayer, David H. Lewis, and Satoshi Minoshima

19a. Review of uses of PET in evaluation of temporal lobe epilepsy--Alexander Hammers, and John S. Duncan

19b. PET is useful in the presurgical evaluation of temporal lobe epilepsy--William H. Theodore

19c. Positron emission tomography need not be used routinely to evaluate patients for temporal lobe surgery--Paul Garcia

CH 20. Single Photon Emission Computed Tomography in Epilepsy--Christopher C. Rowe

20a. Role of Ictal SPECT in Presurgical Evaluation of Extratemporal Epilepsy--Mona Sazgar and Gregory D. Cascino

PART III. Surgical Procedures

Section VIII. Resective surgery for temporal lobe epilepsy--George Ojemann and Taufik Valiante

CH 21. Language mapping for temporal lobe epilepsy

21a. Review of language mapping procedures for temporal resections--Timothy H. Lucas, II, and Daniel L. Silbergeld

21b. Language mapping is necessary for language dominant temporal resections--George A Ojemann,

21c. When is language mapping needed for temporal resections?.--Devin K. Binder, and Nicholas M. Barbaro

CH 22. Intraoperative electrocorticography in the temporal resection.

22a. Review of electrocorticography for tailored mesial temporal epilepsy surgery--Donald F. Farrell, M.D.

22b. Intraoperative electrocorticography is useful in temporal resection--George A Ojemann

22c. Intraoperative electrocorticography has a limited role in the treatment of non-lesional medial temporal lobe epilepsy--Theodore H. Schwartz

CH 23. Is it necessary to include the entorhinal cortex in temporal resections?

23a. Entorhinal cortex in human temporal lobe epilepsy--Neda Bernasconi, Andrea Bernasconi, and Frederick Andermann

23b. It is necessary to include the entorhinal cortex in the temporal resection--Andrew Parrent

CH 24. The selective amygdalohippocampectomy

24a. Review of: selective amygdalohippocampectomy: techniques--Kim J. Burchiel and Joseph Christiano

24b. Selective amygdalohippocampectomy has major advantages--H.G. Wieser

24c. The role of selective amygdalohippocampectomy-Guy McKahn, III

CH 25. Is surgery ever indicated in bitemporal epilepsy

25a. Review: Why worry about bitemporal epilepsy? --Norman So

25b. Role of surgery in bitemporal epilepsy--Mark D. Holmes

25c. The role of surgery in bitemporal epilepsy--Susan S. Spencer

CH 26. Can resection ever be done in the language dominant hemisphere in patients with intact memory?

26a. Resection can be done in the language dominant hemisphere in patients with intact memory, with the correct surgical strategy--George A Ojemann

26b. Temporal lobe resection for epilepsy in the language-dominant hemisphere with normal recent memory on modified Wada test--Antonio V. Delgado-Escueta, Katerina Tanya Perez-Gosiengfiao, Iris E. Martinez-Juarez, Reyna M. Duron, Julia Bailey, Jesus Machado-Salas, Paolo Zolo, Mitchell Kaufman, Richard Daims, Gregory O. Walsh, Antonio De Salles Section IX. Neocortical resections and lesionectomies- Kathleen Tozer and Daniel L. Silbergeld

CH 27. Are multiple subpial transections effective and useful?

27a. Multiple subpial transections: A review, and arguments for use--Allen R. Wyler

27b. Multiple Subpial Transections are not effective or useful--George A Ojemann

CH 28. What is the best way to resect lesions?

28a. Lesionectomy is often adequate for neocortical epilepsy--Aaron A. Cohen-Gadol and Dennis D. Spencer

28b. Lesionectomies should be tailored based on ictal recording--Robert C. Rostomily and Daniel L. Silbergeld

Section X. Corpus callosotomy: Indications, surgical procedures and outcomes--Timothy H Lucas and G. Alexander West

CH 29. Corpus callosotomy: Its place in modern surgical decision making--John R. Gates

CH 30. Indications for corpus callosum section--Márcio A. Sotero de Menezes

Section XI. Hemispherectomy: Hisorical perspective and current surgical overview--Melissa J. Cline and Richard G. Ellenbogen

CH 31. Hemispherectomy: What is the best surgical approach?--Benjamin S. Carson Sr., and George I. Jallo

CH 32. Functional hemispherectomy--Daniel L Silbergeld

CH 33. Peri-insular hemispherotomy--Samuel R. Browd. and John Kestle

CH 34. Hemispherical deafferentation via the transsylvian keyhole--Johannes Schramm

CH 35. Hemicorticectomy--Jeffrey G. Ojemann

Section XII. Vagus nerve stimulation: History and overview--Sandra L. Helmers and Mark D. Holmes, MD

CH 36. The efficacy of vagus nerve stimulation relative to other medical and surgical treatments--Martin C. Salinsky

CH 37. Should the VNS be considered before corpus callosotomy?--Dieter Schmidt

CH 38. Is vagus nerve stimulation therapy effective for generalized epilepsy?--Mark D. Holmes

CH 39. Antiseizure effect of VNS is mediated by ascending pathways--Thomas R. Henry PART IV. Outcomes of Epilepsy Surgery

Section XIII. What is the best way to measure outcome?--Anne T. Berg and Susan S. Spencer

CH 40. Epilepsy surgery outcome measurement requires comprehensive assessment--Frank Gilliam and Jennifer Golstein

CH 41. How often does surgery "cure" drug-resistant epilepsy in adults?--Dieter Schmidt

CH 42. Altered ictal semiology as an outcome of temporal resection --Thomas R. Henry

Section XIV. Outcome of temporal lobe epilepsy surgery--Linda Moretti Ojemann and Matthew E Jung

CH 43. Are prospective, randomized outcome trials necessary? Review: The role of randomized controlled trials in epilepsy surgery--Samuel. Wiebe

CH 44. Prospective controlled randomized trials of epilepsy surgery are necessary-- Jerome Engel, Jr.

CH 45. When are prospective controlled randomized trials of epilepsy surgery really justified?--George A Ojemann

Section XV. Outcomes of extratemporal epilepsy surgery--Eric B. Geller and Orrin Devinsky

CH 46. Neurosurgical treatment is important for non-lesional extratemporal epilepsy--Shahin Hakimian and Jeffrey Ojemann

CH 47. The limited role of resective surgery in non-lesional neocortical epilepsy--Joseph R. Smith, Kostas Fountas, and Don W. King

Section XVI. Psychosocial and vocational outcomes: A perspective on patient rehabilitation--Robert T. Fraser

PART V. Investigational procedures and treatments

CH 48. Use of full-band EEG for non-invasive ictal localization--Sampsa Vanhatalo, John W. Miller, Mark D. Holmes, Kai Kaila, and Juha Voipio

CH 49. Magnetoencephalography (MEG)--Hiroshi Otsubo, Makoto Oishi, and O. Carter Snead III

CH 50. Flumazenil PET--Csaba Juhász and Harry T. Chugani

CH 51. Optical imaging of human neocortical epilepsy--Michael M. Haglund and Daryl W. Hochman

CH 52. Radiosurgery for intractable epilepsy--Jean Régis

CH 53. Deep brain stimulation for epilepsy--David J. Anschel and Robert S. Fisher

CH 54. Prospects for developing electrical stimulation of the cortex for treatment of intractable seizures--Gholam K. Motamedi and Ronald P. Lesser

CH 55. Focal Cortical Cooling--Steven M. Rothman and Xiao-Feng Yang