Advances in Epilepsy Surgery and Radiosurgery by Prof. Dr. med. Heinz Grefor Wieser (auth.), B. Sutter, O.

By Prof. Dr. med. Heinz Grefor Wieser (auth.), B. Sutter, O. Schröttner (eds.)

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Moreover, chronic cerebellar stimulation is more effective in models of generalized or focal epilepsies of the limbic system and less effective in models of focal epilepsies of the sensory-motor cortex. Human studies have shown that chronic cerebellar stimulation may be offered to patients with intractable seizures originating from bilateral or extra temporal foci. Although nonblinded clinical reports are encouraging, double-blind studies showed no benefit [26]. Classical experiments by Dempsey and Morrison [6] demonstrated that the stimulation of the midline thalamus in cats influence cortical EEG.

Extended lesionectomy means complete removal of a lesion which may be combined with amygdalohippocampectomy. Selective amygdalohippocampectomy aims at removal of the mesiotemporal structures which are considered to be critical in the epileptogenesis while completely sparing the temporal neocortex [20, 27]. Since the introduction of selective amygdalohippocampectomy by Niemeyer [15] using the transcortical 30 Fig. 2. Postoperative MRI after right-sided transsylvian selective amygdalohippocampectomy approach, several modifications have been published: the transsulcal, the subtemporal and the transsylvian routes.

Neurology 48: 437-444 53. Li LM, Fish DR, Sisodiya SM, Shorvon SD, Alsanjari N, Stevens JM (1995) High resolution magnetic resonance imaging in adults with partial or secondary generalised epilepsy attending a tertiary referral unit. J Neurol Neurosurg Psychiatry 59: 384387 54. Li LM, Narayanan S, Pike GB, Andermann F, Dubeau F, Arnold DL (2000) Magnetization transfer ratio is unable to lateralize epileptic foci in patients with temporal lobe epilepsy. AJNR 21: 1853-1856 55. Liiders H, Awad I (1992) Conceptual considerations.

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