The first interdisciplinary scientific-practical conference with international participation in Russia “Pre-surgical diagnosis and surgical treatment of pharmacoresistant epilepsy” was held on December 1 at the Pirogov Center. The event was attended by leading experts in this field — neurosurgeons, neurologists, epileptologists, neuroscientists from Moscow and several regions of Russia, as well as from Germany, Switzerland and Italy.
Today, patients with epilepsy are increasingly coming to the aid of neurosurgeons. Epilepsy surgery is a dynamically developing direction. No more than a decade has passed since the first operations in Russia have been performed for patients with pharmacoresistant epilepsy. And if earlier operations were performed by a team of neurosurgeons and anesthesiologists using standard surgical kits, now neuroscience, neurolinguists, and neuropsychologists are also involved in these interventions, and interventions are performed using high-tech equipment. In some cases, intraoperative awakening of the patient is used and the operation is carried out “in consciousness”, which implies special training of operating nurses, the use of short-acting anesthetic drugs, and the participation of a team of neurolinguists.
The use of modern technologies has reduced the risks of such operations to a minimum, and the effectiveness of treatment is increased to 80%. The surgeon can accurately control the area of resection of pathological tissues with maximum preservation of functionally significant areas of the brain. At the same time, the approach has changed not only to surgery of epilepsy itself, but also to the work of specialists in related specialties. It is extremely important to precisely localize the epileptic focus at the pre-surgical stage; in order to achieve this goal it is necessary to use all modern practices in the field of medicine. All the subtleties of a multidisciplinary approach to the treatment of epilepsy were discussed at a conference held by neurologists, neurosurgeons, epileptologists, functional diagnostics doctors, radiologists, rehabilitologists, etc.
Opening the conference, General Director of the Pirogov Center, Professor Oleg Karpov noted the importance of the issues under consideration, the high social relevance of the pathology being discussed and the need for further close cooperation of scientists from Russia and other countries for the effective solution of such significant issues.
The event presented the latest achievements in the diagnosis and surgical treatment of pharmacoresistant forms of epilepsy. Leading Russian and foreign experts shared the first results, features of selection and predictors of success in treating patients with structural forms of epilepsy. The issues of tactics for managing patients with MR negative forms of symptomatic epilepsy, the latest advances in diagnostic technologies for pre-surgical training, the introduction of alternative methods of treatment of difficult patients were discussed.
Professor F. Tomasso (Switzerland) presented a report on the introduction of one of the additional methods of pre-surgical diagnosis in clinical practice and presented a new method for determining the epileptic zone by recording high-frequency oscillations during chronic invasive monitoring. The head of the German Children’s Epileptology Center, Professor Hans Holthausen shared the latest recommendations of the International League Against Epilepsy (ILAE) for conducting pre-surgical diagnosis of epilepsy and the requirements for neurosurgical departments.
The report by Professor Alessandro Ducati (Italy) touched upon the topic of alternative approaches in the treatment of pharmacoresistant epilepsy — chronic stimulation of the vagus nerve (VNS). The reports of the Pirogov Center demonstrated modern features in individual approaches in the treatment of this difficult category of patients.
Experts noted a high level of organization of the event, an interested exchange of opinions and expressed wishes to continue the tradition of holding a conference on the basis of the Pirogov Center.