EVALUAREA PRECHIRURGICALĂ STANDARDIZATĂ ÎN EPILEPSIA FARMACOREZISTENTĂ
DOI:
https://doi.org/10.52692/1857-0011.2025.2-82.08Cuvinte cheie:
drug-resistant epilepsy, presurgical evaluation, video-EEGRezumat
Rezumat. Introducere: Epilepsia farmacorezistentă (EFR) afectează aproximativ o treime dintre pacienții diagnosticați cu epilepsie și se asociază cu o morbiditate semnificativă. Chirurgia epilepsiei reprezintă o opțiune terapeutică eficientă, dar necesită o evaluare prechirurgicală riguroasă pentru a asigura o selecție corectă a candidaților și pentru a minimiza riscurile funcționale. Scopul studiului: De a efectua o sinteză desfășurată asupra etapelor evaluării prechirurgicale standardizate în epilepsia farmacorezistentă, cu accent pe integrarea metodelor neinvazive și invazive în vederea delimitării zonei epileptogene și a protejării ariilor funcționale elocvente. Materiale și metode: A fost realizată o analiză a literaturii de specialiate ce a cuprins studii și publicații relevante care cuprind cele patru faze ale evaluării prechirurgicale, evidențiind valoarea specifică a fiecărei investigații în construirea ipotezei rețelei epileptice. Sunt discutate, de asemenea, aspecte legate de acuratețea, aplicabilitatea și limitările fiecărei metode. Rezultate: Integrarea datelor clinice, neuroimagistice și neurofiziologice într-un cadru multimodal permite localizarea precisă a zonei epileptogene în peste 70% dintre cazurile selectate, crescând șansele de obținere a unei intervenții curative. Cartografierea invazivă funcțională contribuie esențial la reducerea morbidității postoperatorii în intervențiile asupra ariilor corticale elocvente. Concluzii: Evaluarea prechirurgicală multimodală standardizată este esențială în managementul epilepsiei farmacorezistente. Aplicarea etapizată, adaptată individual, a metodelor disponibile asigură selecția optimă a candidaților pentru intervenții rezective, cu un echilibru favorabil între eficiență terapeutică și siguranță funcțională.
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