Textbook of Epilepsy Surgery

Abstract

Hans O. Lüders ( ed .), London, UK : Informa Healthcare , 2008 , Hardcover , 1582 pp . , ISBN-13: 978-1841845760 , Price UK£ 350 . The enormous Textbook of Epilepsy Surgery, edited by H.O. Lüders (Epilepsy Center, Neurological Institute at Case Western Reserve Medical Center, Cleveland, OH, USA) who previously edited the book Epilepsy Surgery, Raven Press 1992, is a seminal and timely review of the latest advances in the surgical management of epilepsy. It contains 165 chapters in 21 definite sections, written by an international panel of specialists and authorities. After an overview of the history of epilepsy surgery and related fields from early Asian history and the 19th century to modern times with contributions from various countries all over the world and the history of seizure classification and neuroimaging in pre-surgical evaluation, section 2 – overview – discusses the epidemiology, genetic factors of intractable epilepsy, costs and quality of life of epilepsy surgery, patient selection and exclusion criteria. Section 3 – epilepsy remediable by epilepsy surgery – presents various lesion types (mesial temporal, frontal, basal frontal lobe, pre-motor and central lobe, parieto-occipital, insular, cingulate epilepsy, hypothalamic hemartoma, Rasmussen, Landau-Kleffner, Lennox-Gastaut and other infantile syndromes). Sections 4 and 5 are dedicated to general principles of pre-surgical evaluation, followed by the symptogenetic zone with localizing value of auras, autonomic, simple and complex motor seizures, dialeptic, special and secondary generalized seizures. Section 6, the irritative zone, describes its evaluation by electroencephalography, invasive recording, magnetoencephalography, modern digital tools and special methods for source localization, pros and cons of antiepileptic drug withdrawal, and the effects of sleep and sleep deprivation. The next section – the ictal onset zone – discusses non-invasive electroencephalography, indications for invasive evaluations, long-time monitoring, epidural and subdural electrodes, stereoencephalography, ictal DC recordings, functional magnetic resonance tomography, ictal SPECT, automatic detection of epileptic seizures, ‘preictal’ predictors, and electrical stimulation induced seizures. Section 8 – the epileptic lesion – reviews MR imaging in different types of epilepsy including neurocutaneous syndromes, neoplasms, MR spectroscopy, post-processing of MRI to better define structural abnormalities, and multimodal image processing in pre-surgical planning. The next section describes the functional deficit zone, the impact of positron emission tomography in various forms of epilespy, pre-surgical neuropsychologic workup, risk factors for post-surgical deficits, Wada-Test and epileptogenic zone, and event-related potentials. Section 10 – pre-surgical evaluation of eloquent cortex – reviews non-invasive evaluation methods. The next section – the epileptic zone – shows further methods for its direct assessment. Section 12 describes the patient management meeting conference, followed by extensive reviews of the surgical techniques for placement of intracranial electrodes, anesthesia for epilepsy surgery, placement of subdural grids, deep electrodes, and stereoencephalography. Section 14 – cortical mapping and electrocorticography – describes various methods for cortical mapping with subdural electrodes, by electrical stimulation, evoked potentials and Bereitschaftspotential, the role of magnetoencephalography and of cortico-cortical potentials to define eloquent cortex, mapping by intra-operative optical imaging, and functional location with deep electrodes. A major section is dedicated to resective surgical procedures for mesial temporal epilepsy, neocortical resection techniques, management of vascular malformations, and hemispherectomy. Section 16 – non-resective surgical procedures and electrical or magnetic stimulation for epilepsy treatment – discusses multiple subpial transections, multiple hippocampal transection, surgical disconnections of the epileptic zone, corpus callosotomy, radiosurgical treatment, vagal nerve stimulation (experimental data and human studies), experimental evidence for the involvement of basal ganglia in the control of epilepsy, and repetitive transcranial magnetic stimulation. Section 17 is dedicated to surgical outcome, presenting data on post-surgical seizure frequency after mesial temporal lobectomy and hemispherectomy, resective surgery in children, sudden unexpected death after epilepsy surgery, psychosocial, neuropsychological and quality of life outcome, and surgical complications. Follow chapters on post-surgical management (early post-surgical, post-surgical pharmacotherapy and rehabilitation). Section 19, dedicated to neuropathology and research related to epilepsy surgery, describes neuropathology of mesial temporal sclerosis, neocortical epilepsy, malformations of cortical development, various other abnormalities associated with epilepsy, epileptogenic neoplasms, in vitro neurophysiological and cytochemical studies, and animal models of epilepsy relevant for transitional research. Section 20 – surgical failures: reoperation – discussing pre-surgical evaluation and reoperation after failed epilepsy surgery, is followed by illustrative case presentations and discussions, while the appendices present essentials for the establishment of an epilepsy surgery programme, classification of seizure outcome following surgery, and a protocol for storage and processing of brain tissue for molecular studies. All chapters are concise, well organized with initial presentation of general principles, informative subheadings and many excellent figures, schemes and tables as well as extensive reference lists ending 2005 (in which some overlap may be seen). This fully comprehensive textbook that covers all problems of epilepsy surgery and related fields is an invaluable tool and reference source for neurologists, neurosurgeons, epilepsy specialists and all those interested in seizures and its surgical treatment. It is worth its price.