1. Epilepsy surgery

2. History

13. Definition
Seizure
Convulsion
Epilepsy

14. Epidemiology
Prevalence : 52,000,000 around the world
700,000 in Iran

16. Pathophysiology Developmental pathology of brain
Neuronal and glial disorders
Kindling phenomenon
Reorganization of cortical tissue in response to hypoxia

17. Kindling phenomenon

18. Treatment Standard : monotherapy by antiepileptic drugs
Traditional : phenobarbital , phenytoin , primidone , carbamazepine , valproic acid
New : lamotrigine , topiramate , levatiracetam ,…

19. Failure of medical therapy
Misdiagnosis
Irregular follow up
Irregularity in treatment
Life style factors
Brain tumors
Sever traumatic brain injury

20. Refractory epilepsy
30 % of patients

21. Causes of refractory epilepsy
Temporal lob epilepsy : the most common
Neuronal structural disorders
Inflammatory disorders
Autoimmune mechanisms
Tumors and sever traumatic brain injuries

22. Temporal lobectomy and lesionectomy

40. Callosotomy

48. Indications
Tuberos sclerosis
Infantile spasm
Lenox – Gustaut syndrome

50. Hemispher - ectomy , tomy

51. Rasmussen's encephalitis

54. Multiple subpial transection

57. Vagal nerve stimulation

58. Mechanism
Nor epinephrine
GABA
Reticular activating system