Revue médicale suisse
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Revue médicale suisse · May 2010
Editorial Historical Article[The treatment of epilepsy in the 21st century].
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In some patients with refractory epilepsy, no resective surgery of the epileptogenic zone can be offered. This is the case when for instance the epileptogenic zone is located in an eloquent region (motor, language or visual) or when there are several epileptogenic zones. ⋯ Among these procedures, we review briefly here vagus nerve stimulation, the various brain stimulations procedures, multiples subpial transsections, and the corpus callosotomy. For each procedure, we will discuss its indication and outcome.
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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.