Epilepsy surgery and operable
lesions such as FCDs

Epilepsy surgery treatment

Epilepsy surgery may be considered, for example, if a patient's focal epilepsy is drug-resistant, i.e. if a patient has not become seizure-free despite treatment with two appropriate anti-seizure medications at sufficiently high doses.

A prerequisite for epilepsy surgery by a neurosurgeon is, on the one hand, that the source causing the epilepsy – the so-called epileptogenic lesion – is visible on the head MRI at all and, on the other hand, that this lesion is located so favorably that removing it causes no damage or no excessive damage.

In order to detect epileptogenic lesions, a high-quality, high-resolution head MRI optimized for epilepsy should be available.

Unfortunately, even with high-quality MRIs, small epileptogenic lesions such as FCDs are repeatedly overlooked when the images are read.

It is very important that precisely such small lesions are recognized on supposedly unremarkable head MRIs, because the complete surgical removal of an FCD can cure the epilepsy of a drug-resistant patient.