Introduction The surgical treatment of movement disorders has evolved considerably over the past 20 years with the increasing application of deep brain stimulation (DBS), principally for the treatment of Parkinson disease (PD), essential tremor, and dystonia. The sites most commonly…
History of Dystonic Conditions One of the earliest descriptions of dystonia was recorded by Gowers in 1888. Destarac in 1901 used the term “torticollis spasmodique” to describe the twisting neck movements observed in a 17-year-old girl. Dystonic conditions were identified…
Introduction Deep brain stimulation (DBS) has proven to be an effective treatment for symptoms of Parkinson disease (PD), essential tremor (ET), congenital or acquired dystonias, and other movement disorders. Although not currently practiced outside of clinical trials, DBS for medically…
Introduction The surgical management of patients with drug-resistant epilepsy is changing rapidly as newer methods of diagnosis and treatment are discovered and enter clinical practice. The International League Against Epilepsy defines drug-resistant epilepsy as seizures that continue despite treatment with…
In 1940, William P. van Wagenen and R. Yorke Herren described a small series of patients with various disruptive lesions of the corpus callosum. Their report highlighted the phenomenologic distinction between generalized convulsive seizures in individuals with tumors near the…
Multilobar Resections The rationale of curative surgical procedures aiming at control of focal drug-resistant epilepsy is total inactivation (by resection or disconnection) of the epileptogenic zone (EZ) (i.e., the cortical region of onset and early spread of an ictal discharge).…
Introduction Extratemporal lobe epilepsy (ETLE) comprises debilitating conditions of heterogeneous symptomatology and pathology, both challenging to diagnose and to treat yet amenable to several surgical interventions. ETLE is defined as localization-related epilepsy with the electrophysiological epileptogenic zone outside the temporal…
Epilepsy affects 1% of the world’s population and incurs an enormous burden of disease. One-third of patients with epilepsy fail to achieve adequate seizure control with antiepileptic drugs or cannot tolerate their side effects. In temporal lobe epilepsy, patients may…
Introduction When we decide that surgery is an option for treating epilepsy, there are a number of considerations we have to make. First and most important, the decision of operating on a patient with seizures does not reside in one…
Introduction Laser interstitial thermal therapy (LITT) is a minimally invasive percutaneous procedure that involves the stereotactic insertion of a fiberoptic catheter and delivery of non-ionized photons into a predetermined intracranial location to thermally ablate specific anatomical structures or lesions. Laser…