OVERVIEW
Epilepsy surgery offers hope to patients afflicted with drug resistant seizures, and can lead to significant improvements in their quality of life, including seizure freedom. As many as one million patients are potential candidates for epilepsy surgery in the United States, and yet surgical volumes are not improving, implying that barriers continue to limit the adequate referral and surgical work-up of these patients. Moreover, with the majority of open surgical epilepsy procedures now focused to a smaller number of specialized centers, adequate training in the art of open techniques is becoming a lost skill.
The goal of the Cleveland Clinic Techniques in Epilepsy Surgery course is to provide a hands-on educational forum for seasoned epilepsy neurosurgeons to interact with young neurosurgeons- in-training and junior neurosurgery faculty. Basic anatomy, historical themes, detailed epilepsy surgery techniques and representative case presentations will be reviewed in both the classroom and laboratory setting. Indications regarding open resection versus neuromodulation will be emphasized. The topics of robotic stereotactic surgery, laser ablation, vagal nerve stimulation, responsive neurostimulation, deep brain stimulation and focused ultrasound will also be reviewed, spanning the armamentarium of innovative techniques available to the aspiring epilepsy neurosurgeon of the modern era. The neurosurgical lab at Lutheran hospital will be utilized to demonstrate and offer hands-on practice of core epilepsy surgical techniques using cadaveric anatomical specimens. Additionally, strategies for developing an epilepsy surgery practice, and inherent challenges to successful epilepsy surgery, will be highlighted. Ultimately, this course is dedicated to training the next generation of emerging surgical leaders in epilepsy, in a collaborative and collegial environment, to improve care for epilepsy patients around the country.
WHO SHOULD ATTEND?
This educational activity is intended for neurosurgeons interested in epilepsy surgery.
LEARNING OBJECTIVES
After completing this educational activity, participants will be able to do the following:
- Describe the surgical anatomy of the temporal lobe and how the underlying pathology relates to the choice of surgical technique.
- Summarize the overall outcomes from surgeries for treating patients with epilepsy.
- Demonstrate the basic surgical techniques necessary to complete a functional disconnection of the epileptic cerebral hemisphere.
- Discuss the complexity of identifying ictal onsets in cortical regions outside the temporal lobe and identify specific techniques that allow safe surgical resection in eloquent cortex areas.
- Debate the rationale and show the appropriate techniques for placement of intracerebral electrodes to prove a hypothesis of seizure onset based on individual patient characteristics.
- Demonstrate the techniques of and rationale for of vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation therapies.