About epilepsy: extratemporal cortical resection

What is epilepsy: extratemporal cortical resection?

The largest part of the brain, the cerebrum, is divided into four paired sections, called lobes -- the frontal, parietal, occipital, and temporal lobes. Each lobe controls a specific group of activities. With temporal lobe epilepsy, which is the most common type of epilepsy in teens and adults, the area where the seizures start -- called the seizure focus -- is located within the temporal lobe. However, seizures can start in any portion of the cerebral cortex, the outer layer (gray matter) of the cerebrum.

What Is an Extratemporal Cortical Resection?

In epilepsy, an extratemporal cortical resection is an operation to resect, or cut away, brain tissue that contains a seizure focus. Extratemporal means the tissue is located in an area of the brain other than the temporal lobe. The frontal lobe is the most common extratemporal site for seizures. In some cases, tissue may be removed from more than one area/lobe of the brain.

Who Is a Candidate for Extratemporal Cortical Resection?

Extratemporal cortical resection may be an option for people with epilepsy whose seizures are disabling and/or not controlled by medications, or when the side effects of the medication are severe and significantly affect the person's quality of life. In addition, it must be possible to remove the brain tissue that contains the seizure focus without causing damage to areas of the brain responsible for vital functions, such as movement, sensation, language and memory.

What Happens Before an Extratemporal Cortical Resection?

Candidates for extratemporal cortical resection undergo an extensive pre-surgery evaluation including video electroencephalographic (EEG) seizure monitoring, magnetic resonance imaging (MRI), and positron emission tomography (PET). Other tests include neuropsychological memory testing, WADA test (to lateralize the side of language), ictal SPECT, and magnetic resonance spectroscopy. These tests help to pinpoint the seizure focus and determine if surgery is possible.

What Happens During an Extratemporal Cortical Resection?

An extratemporal cortical resection requires exposing an area of the brain using a procedure called a craniotomy. After the patient is put to sleep (general anesthesia), the surgeon makes an incision in the scalp, removes a piece of bone and pulls back a section of the dura, the tough membrane that covers the brain. This creates a "window" in which the surgeon inserts special instruments to remove brain tissue. Surgical microscopes are used to give the surgeon a magnified view of the area of the brain involved. The surgeon utilizes the information gathered during the pre-operative evaluation -- as well as during surgery -- to define, or map out, the route to the correct area of the brain.

In some cases, a portion of the surgery is performed while the patient is awake, using medication to keep the person relaxed and pain free. This is done so that the patient can help the surgeon find and avoid areas in the brain responsible for vital functions such as brain regions of language and motor control. While the patient is awake, the doctor uses special probes to stimulate various areas of the brain. At the same time, the patient may be asked to count, identify pictures, or perform other tasks. The surgeon can then identify the area of the brain associated with each task. After the brain tissue is removed, the dura and bone are fixed back into place, and the scalp is closed using stitches or staples.

What are the symptoms for epilepsy: extratemporal cortical resection?

Confusion symptom was found in the epilepsy: extratemporal cortical resection condition

Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing Seizures or periods of unusual behavior, sensations and sometimes loss of awareness . Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages ecause epilepsy is caused by abnormal activity in the brain, Seizures can affect any process your brain coordinates. Seizure signs and symptoms may include: • Temporary confusion • A staring spell • Stiff muscles • Uncontrollable jerking movements of the arms and legs • Loss of consciousness or awareness • Psychological symptoms such as fear, Anxiety or deja vu Doctors generally classify Seizures as either focal or generalized, based on how and where the abnormal brain activity begins. Focal seizures When Seizures appear to result from abnormal activity in just one area of your brain, they're called focal seizures. These Seizures fall into two categories: • Focal Seizures without loss of consciousness . Focal Seizures with impaired awareness. . Generalized seizures Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized Seizures exist. • Absence seizures. typically occur in children. They're characterized by staring into space with or without subtle body movements such as eye blinking or lip smacking and only last between 5-10 seconds. • Tonic seizures. Tonic Seizures cause stiff muscles and may affect consciousness. • Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control. • Clonic seizures. • Myoclonic seizures. . • Tonic-clonic seizures

What are the causes for epilepsy: extratemporal cortical resection?

Every year, there are about 180,000 new instances of epilepsy. 30% of cases include youngsters. The most frequently impacted groups are young people and senior citizens. Only a small percentage of cases of epilepsy have a known cause. The recognised causes of seizures frequently entail a brain damage. The following are some of the main causes of epilepsy: Family background. Genes are important. Up to 40% of all epilepsy cases are caused by a person's genetic composition, which increases their risk of developing the condition. Epilepsy is caused by multiple genes, not just one. In fact, according to some experts, there might be 500. You have a larger probability of developing epilepsy than someone who doesn't if your parent or sibling has it. Although doctors are unsure of how it is handed on, they speculate that it may be linked to a gene mutation that affects the nerve cells in the brain. Having this mutation does not guarantee that you will get epilepsy. The mix of genetics and another factor, such as a medical condition, may be to blame, according to experts. Injury sustained prior to, during, or shortly after birth. Epilepsy risk increases with any issues with brain development in the womb or during the first few months of life. Babies in the womb may suffer from brain injury for a variety of reasons, including: the mother's infection unsound nutrition inadequate oxygen

What are the treatments for epilepsy: extratemporal cortical resection?

An extratemporal cortical resection is an operation to resect, or cut away, brain tissue that contains a seizure focus. Extratemporal means the tissue is located in an area of the brain other than the temporal lobe. The frontal lobe is the most common extratemporal site for seizures. In some cases, tissue may be removed from more than one area/lobe of the brain. Extratemporal cortical resection may be an option for people with epilepsy whose seizures are disabling and/or not controlled by medications, or when the side effects of the medication are severe and significantly affect the person's quality of life. In addition, it must be possible to remove the brain tissue that contains the seizure focus without causing damage to areas of the brain responsible for vital functions, such as movement, sensation, language, and memory. An extratemporal cortical resection requires exposing an area of the brain using a procedure called a craniotomy. After the patient is put to sleep (general anesthesia), the surgeon makes an incision in the scalp, removes a piece of bone and pulls back a section of the dura, the tough membrane that covers the brain. This creates a "window" in which the surgeon inserts special instruments to remove brain tissue. Surgical microscopes are used to give the surgeon a magnified view of the area of the brain involved. The surgeon utilizes the information gathered during the pre-operative evaluation -- as well as during surgery -- to define, or map out, the route to the correct area of the brain.

What are the risk factors for epilepsy: extratemporal cortical resection?

The risks associated with extratemporal cortical resection mainly depend on which area of the brain is involved. They may include:

  • Risks associated with surgery, including infection, bleeding, and an allergic reaction to anesthesia
  • Swelling of the brain
  • Failure to relieve seizures
  • Changes in personality or behavior
  • Partial loss of vision, memory, or speech
  • Stroke, paralysis, weakness, limb numbness

 

Is there a cure/medications for epilepsy: extratemporal cortical resection?

Epilepsy treatment options include: • Anti-epileptic (anticonvulsant, antiseizure) drugs. Anti-epileptic medications can help reduce the number of seizures you have. In some people, they may eliminate seizures. To be most effective, the medication must be taken exactly as your doctor prescribed. • Vagus nerve stimulator. This device is surgically placed under the skin on your chest and electrically stimulates the nerve that runs through your neck to prevent seizures. • Brain surgery. The area of the brain that causes seizure activity can be removed or altered if you and your healthcare team determine it’s the right treatment for your condition. Minimally invasive surgeries and radiosurgery are also being investigated. Medications for epilepsy The first-line treatment for epilepsy is antiseizure medication. These drugs are designed to help reduce the frequency and severity of seizures. They cannot stop a seizure that’s already in progress, and they are not a cure for epilepsy. These medications are absorbed by your stomach. They then travel through your bloodstream to your brain. They affect neurotransmitters in a way that reduces the electrical activity that leads to seizures. There are many antiseizure drugs on the market. Your doctor can prescribe a single drug or a combination of drugs, depending on your type of seizure. Common epilepsy medications include: • levetiracetam (Keppra) • lamotrigine (Lamictal) • topiramate (Topamax) • valproic acid (Depakote) • carbamazepine (Tegretol) • ethosuximide (Zarontin)

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