Advances in Stereotactic and Functional Neurosurgery 4: by Gábor Szikla (auth.), F. John Gillingham, Jan Gybels, Edward

By Gábor Szikla (auth.), F. John Gillingham, Jan Gybels, Edward Hitchcock, Gian Franco Rossi, Gábor Szikla (eds.)

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Additional info for Advances in Stereotactic and Functional Neurosurgery 4: Proceedings of the 4th Meeting of the European Society for Stereotactic and Functional Neurosurgery, Paris 1979

Sample text

The operated hemisphere studied in terms of speech dominance (Fig. 7) shows that most surgical procedures concern the right hemisphere (153 compared to 67 on the left) and procedures are still 60 A. Bonis: more predominant on the minor hemisphere (172 compared to 48 on the major hemisphere). At first sight, this predominance seems easy to explain. However a detailed study on 48 procedures on the major hemisphere including several evolutive tumours leads to the conclusion that sometimes we are overcautious in that respect and that indication of surgical procedures could be taken into consideration more frequently for epilepsies of the dominant hemisphere.

This requires precise observation, description (magnetophone) and reconstruction (magnetoscope) in terms of recorded EEG sequences. ). Spontaneous seizures or seizures induced through hyperpnea or through peripheral stimulations must be recorded. These seizures are, in our opinion, the best criterion for a topographic definition of epileptogenic areas in order to plan a stereo-EEG investigation. However, the patient should be submitted to chemical activators (Megimide or Metrazol), especially whenever these activators are used during the stereo-EEG exploration, which is frequently the case.

We cannot enter into the details of this complex matter here and will just mention the most important elements. a) The first aim, through the results of the previous examinations, particularly of the stereotactic neuroradiological studies, is to try to determine the extension and the importance of the epileptogenic lesion. Advances 4 3 34 J. Bancaud: Surgery of Epilepsy Based on Stereotactic Investigations It should however be recalled that the notion of lesion is quite ambiguous, especially in the field of epilepsy.

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