Stereotactic Treatment of Epilepsy

has further broadened controversial though this subject and indeed the results of amygdaloidotomy may be. lt was Jinnai in 1963 who first published his work on the control of intractable epilepsy by interruption of conduction pathways of the epileptic discharge using stereotactic lesions in the field of Forel. This was followed by lesions in the thalamus by Mullen in 1967, and by capsular lesions by Bertrand in 1970 and myself in 1971. In the macroscopic form this was carried out by section of the inter hemispheric cerebral connections by open operation by Vogel in 1969. This has been an important contribution to knowledge of the basic mechanisms of the propagation of the epileptic discharge and to our understanding of brain function but I would look to stereotactic techniques for the greater development potential. There are, of course, limitations. Bilateral lesions of effective size are difficult to achieve without side effects, particularly in respect of speech (notably dysarthria) and yet are essential if intractable epilepsy is to be con trolled in severity and frequency. Increased accuracy of target siting and control of the size of lesion are not the whole answer for inevi tably there are areas where important neuronal circuits are very crowded. But we should not underestimate the contribution of surgery. Increasingly the medical therapy of epilepsy is under scrutiny.

Inhalt
Chronic Electrodes in SEEG Exploration of Partial Epilepsies.- The Role of Focal and Extrafocal Structures in the Triggering of Epileptic Spikes: An Experimental Study.- The Value of Electrostimulation in Epileptic Focus Localization.- Graphic Representation of the Epileptic Focus.- Stereoelectrosubcorticography in Epilepsy, the Focus and Epileptogenic System.- An Analysis of Routine-EEG-Findings with a View to Surgical Treatment of Epilepsy.- The Seizure Active Site Demonstrated by Chronically Implanted Electrodes.- Multifocal Epilepsy: Surgical Treatment after Stereo-EEG Study.- The Motor Mechanism of Some Types of Epilepsy.- Clinical and Electrophysiological Effects of Chronic Epileptic Lesion in Split-Brain Cats.- Determination of the Functional Hierarchy in Multifocal Epilepsy.- Computer Analysis of the Telemetered EEG in the Study of Epilepsy and Schizophrenia.- Investigation of Epileptic Structure Properties by Transfer Function.- Catecholamine Levels in Penicillin-Induced Epileptic Focus of the Cat Cerebral Cortex.- Antivitamin B6 Induced Ultrastructural Changes in the Hippocampus of the Convulsant Rabbit and Its Biochemical Correlates.- Formation of Glutamate and GABA in Epileptogenic Tissue from Human Hippocampus in vitro.- Anatomical Rationale of Ablative Surgery for Temporal Lobe Seizures and Dyscontrol: Suggested Stereo-Chemode Chelate-Blockade Alternative.- Carotis Hexobarbital Test; a Method for Investigation of Interhemispherial Synchrony in Generalized Spike-Wave Mechanisms.- Anatomo-Physiological Variability of Deep Brain Structures and Stereo-Neurosurgery of Epilepsy.- Some Electrophysiological Characteristics of the Spontaneous Activity of the Amygdala and Effect of Hypothalamic Stimulation on the Amygdalar Units Responses.- Contribution toSurgical Terminology in Epilepsy.- Conventional Surgery in Epilepsy.- Application with Classic Craniotomy in the Treatment of Focal Epilepsy.- Stereotactic Treatment of Epilepsy in the Light of Pathophysiological Disease Concept.- Forel-H-Tomy for the Treatment of Intractable Epilepsy.- Stereotactic Fornicotomy in Temporal Epilepsy: Indications and Long-Term Results.- Late Results of Stereotactic Surgery of Epilepsy Predominantly Temporal Lobe Type.- Stereo-Electroencephalographic Exploration and Epilepsia Partialis Continua.- Basic Targets and the Different Epilepsies.- Effects of Stereotactic Operations in the Treatment of EpilepsiesNeurological Aspects.- Effects of Stereotactic Lesions in Intractable Epilepsy.- New Possibilities of Stereotactic Treatment of Temporal Lobe Epilepsy (TLE).- Results of Amygdalotomy and Fornicotomy in Temporal Lobe Epilepsy and Behaviour Disorders.- Stereotactic Amygdalotomy in the Light of Neut.opsychological Investigations.- Stereotactic Surgery of the Limbic System in Epilepsy.- Stereotactic Lesions of the Amygdala and Hippocampus in Epilepsy.- Lessons from Amygdaloid Surgery in Long-Term Observation.- Evaluation of Psychopathological Changes in Epileptic Personality after Stereotactic Treatment.- Centrencephalic Epilepsy and Suboccipital Derivations.- Some Observations in Treatment Stimulation of Epilepsy.- Stereotactic Lesions for the Control of Intractable Epilepsy.- Experiences with Pharmacological Methods for the Lateralization of Temporal Epileptic Foci.