Revue médicale suisse
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Epilepsy surgery is possible in specific cases of localisation-related pharmaco-resistant epilepsy and can often lead to seizure-freedom condition. A presurgical diagnostic workup is necessary to localise the epileptic focus and assess the risks of post-operative neurological or cognitive deficits. ⋯ All patients suffering from pharmaco-resistant epilepsy should be referred to an expert centre to confirm the diagnosis and evaluate the possibility of epilepsy surgery. In children, early epilepsy surgery can allow better continuation of cognitive development and education.
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Revue médicale suisse · May 2010
Editorial Historical Article[The treatment of epilepsy in the 21st century].
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Normal pressure hydrocephalus (NPH) is characterized by a classic triad of symptoms including gait disturbance, urinary incontinence, and dementia. NPH is associated with a radiological verifiable ventriculomegaly in the absence of elevated cerebrospinal fluid (CSF) pressure. ⋯ Various supplemental preoperative tests, including lumbar CSF tap test or CSF outflow resistance determination, can improve the accuracy of predicting a response to surgical intervention. CSF shunt results in significant reduction of the symptoms in the majority of appropriately evaluated patients.