Epilepsy and Surgical Therapy

TOPICAL HEADINGS Introduction Preliminary case study Pattern of attack Neurologic signs Encephalography Electrical exploration Idiopathic (essential) epilepsy Pathologic physiology Results of sympathetic ganglionectomy Results of removal of carotid body and denervation of the carotid sinus Results of subtemporal decompression Results of spinal insufflation of oxygen Epileptiform seizures secondary to subdural exudation Epilepsy associated with injury at birth and with congenital abnormality of the brain Epileptiform seizures secondary to intracranial tumors Epileptiform seizures associated with meningocerebral cicatrix, cerebral cicatrix and cerebral atrophy Pathologic anatomy Results of craniotomies Radical excision Exploration without excision Ligation of cerebral arteries Evacuation of subdural fluid Summary and comment INTRODUCTION Surgical intervention should be employed in the treatment of epilepsy only when the operator has studied carefully the physiologic mechanism and the pathologic cause in the individual instance. The surgeon who performs a craniotomy without a carefully considered constructive hypothesis "places himself on a level with the