An extratemporal cortical resection in epilepsy is a procedure to resection or cut off brain tissue containing a seizure focus. Extratemporal means that the tissue is located in a different area from the temporal lobe in the brain. For epilepsy, the frontal lobe is the most prevalent extratemporal site. Tissue can be separated from more than one area or lobe of the brain in some circumstances.
SYMPTOMS
Side Effects of ECR
These symptoms may occur after an ECR operation, although they generally go away on their own.
Risks of ECR associated with the surgery
TREATMENT
Extratemporal cortical resection can be an alternative for individuals with epilepsy whose seizures are physically impaired and/or not managed by medication, or where the medication’s side effects are serious and disabling.
ECR candidates then undergo a thorough pre-surgery examination, including magnetic resonance imaging (MRI), video electroencephalographic (EEG) or seizure monitoring, and positron emission tomography (PET). WADA (lateral language lateralization) testing, neuropsychological recall testing, magnetic resonance spectroscopy, and ictal SPECT are additional tests that help pinpoint the focus of epilepsy and assess if surgery is necessary.
An ECR procedure involves using a technique called a craniotomy, or opening a region of the brain. The surgeon makes an incision in the scalp, cuts a piece of bone, and draws back a part of the dura, the tough membrane that protects the brain after the patient is put to sleep (general anesthesia). This provides a “window” where special devices are inserted by the surgeon to extract brain tissue. Surgical microscopes are used to provide a magnified image of the brain region involved to the surgeon.
After an ECR, the patient normally remains in the hospital after surgery for two to four days. After treatment, most people may need to continue to take anti-seizure medications for two or more years, medications can then be lowered or removed until seizure attacks recede.
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