Presurgical evaluation in patients with remote symptomatic epilepsy

Publisher Summary This chapter discusses the presurgical evaluation in patients with remote symptomatic epilepsy. Several central nervous system (CNS) lesions acquired postnatally may cause remote symptomatic epilepsy and these include: perinatal hypoxic ischaemic insult, traumatic brain injury, cerebrovascular disease, and CNS infection. Seizure semiology, electroencephalography (EEG) and magnetic resonance imaging findings, and surgical outcome are discussed for each of these causes of epilepsy. The presurgical evaluation in patients with intractable epilepsy after stroke is given in this chapter. In general, the incidence of seizures after stroke ranges between 4% and 10%. In the seizure after stroke study, 2021 patients with hemispheric strokes were followed prospectively in a multicenter study. The incidence of acute seizures in ischemic strokes was 8.6% and in hemorrhagic strokes was 10.6%. The incidence of epilepsy (recurrent unprovoked seizures) after stroke was 2.5%. Epilepsy developed in approximately half of the patients with seizures occurring in 2 weeks after ischemic stroke and in all the patients with seizures starting after 2 weeks from the hemorrhagic stroke.