Surgical Strategies for Epilepsy in Eloquent Areas

Abstract

Patients with medically refractory epilepsy should be evaluated for potentially curative epilepsy surgery when feasible. However, if seizure foci occur in eloquent brain regions—regions where damage causes overt neurological deficits—alternative treatments must be considered. This review will discuss what defines eloquent cortex, and the various treatments of seizure foci in eloquent regions, including resective surgery, multiple subpial transections, electrical brain stimulation of the anterior nucleus of the thalamus, closed-loop responsive neurostimulation, and vagus nerve stimulation.