MODERN SURGICAL STRATEGIES IN DRUG-RESISTANT EPILEPSY: RESECTION OF EPILEPTIC FOCI, MINIMALLY INVASIVE METHODS, AND NEUROSTIMULATION
Abstract
Introduction: Drug-resistant epilepsy (DRE) affects approximately one-third of patients with epilepsy and represents a significant clinical challenge. When adequate seizure control cannot be achieved with antiseizure medications, alternative therapeutic strategies, including surgical and neuromodulatory approaches, must be considered to reduce seizure burden and improve quality of life.
Methodology: This review is based on an analysis of contemporary scientific literature focusing on surgical, minimally invasive, and neuromodulation-based treatments for drug-resistant epilepsy. Studies published in recent years were reviewed to evaluate treatment efficacy, safety profiles, and long-term outcomes.
Results: Resective surgery, particularly anterior temporal lobectomy and selective amygdalohippocampectomy, remains one of the most effective treatment for appropriately selected patients, achieving long-term seizure freedom in approximately 60–70% of cases. Minimally invasive techniques such as laser interstitial thermal therapy (LITT) and stereotactic radiosurgery (Gamma Knife) offer favorable seizure outcomes with reduced morbidity and shorter hospitalization. Neuromodulation methods, including vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation, provide significant seizure reduction and improved quality of life in patients who are not candidates for resective surgery.
Conclusion: The management of drug-resistant epilepsy requires an individualized, multidisciplinary approach. Advances in minimally invasive surgery and neuromodulation expand therapeutic options, allowing for tailored treatment strategies that balance efficacy and safety. Continued research and technological development remain essential to optimize outcomes for patients with DRE.
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