epileps. surgery

Question 1

who is surg best for

Answer 1

focal seizures of the temporal lobe

Question 2

2 requirments for surg

Answer 2

1. medical refractory

2. focal seizure

Question 3

what type of seizure has best chance of surg. cure

Answer 3

complex partial - least chance on meds

Question 4

what is cure rate for TLE

Answer 4

80-90%

Question 5

time between first seizure and surgery

Answer 5

22 years

Question 6

what is major temp. lobe structures involved in seizure

Answer 6

hippocampus and amygdala

Question 7

what are 4 prodrome (aura) Sx

Answer 7

1. deja vu - hippocampus memory
2. smell - uncus
3. fear and anxiety - amygdala
4. autonomic manifestation - rising feeling in abdo

Question 8

5 features of TLE seizure

Answer 8

1. blank stare
2. automatic behavior
3. facial movements
4. speech arrect
5. wandering

Question 9

5 post-ictal Sx

Answer 9

1. tired
2. headache
3. disoreitned
4. psychotic
5. depressed

Question 10

what is mesial temporal sclerosis

Answer 10

most common cause of TLE - atrophy of the hippocampal formation

Question 11

what is NNT for surgery

Answer 11

2

Question 12

3 functions of temp. lobe

Answer 12

1. visual/spatial
2. verbal memory
3. language

Question 13

what is point of neuropsych

Answer 13

1. assess dominance
2. assess memory
3. assess language

Question 14

what is risk in surgery (5)

Answer 14

1. loss of memory, especially if done on side of language
2. loss of language
3. visual field cut
4. stroke
5. infection/hemmorage

Question 15

benefits of surg

Answer 15

1. QOL
2. reduced mortality
3. reduced dep
4. employment/earnings
5. independence
6. meds