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      RECURRENCIA DE CRISIS EPILÉPTICAS POST TRATAMIENTO QUIRÚRGICO PARA CIRUGÍA EPILEPSIA EN EL SERVICIO NEUROCIRUGÍA DEL HOSPITAL MATERNO INFANTIL Translated title: RECURRENCE OF SEIZURES POST SURGICAL TREATMENT FOR EPILEPSY SURGERY NEUROSURGERY SERVICE IN "HOSPITAL MATERNO INFANTIL"

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          Abstract

          El concepto clínico y epidemiológico de epilepsia como enfermedad crónica recomendado por la OMS y la ILAE exige la repetición crónica de crisis epilépticas1,2. La epilepsia se clasifica en sintomático, criptogenetica e idiopática¹. Esta descrito que aproximadamente el 1 % de toda la población mundial tiene Epilepsia, siendo una patología muy frecuente y de gran interés en la salud pública, por lo cual la posibilidad de obtener una cura o una mejoría significativa mediante el tratamiento quirúrgico es un campo de investigación en constante crecimiento. Se sabe que la conducta quirúrgica se debe realizar en los pacientes con Epilepsia Sintomática que representan el 40 a 60% de los casos. Los pacientes con epilepsia refractaria al tratamiento son el 10% y son estos los candidatos al tratamiento quirúrgicos por Neurocirugía Funcional, obteniéndose un resultado favorable en más del 60% de los pacientes operados(1,2,3,4,5,6,7). En el presente trabajo tiene por objetivo determinar la Recurrencia de Crisis Epilepticas Asociada al tratamiento quirúrgico para epilepsia según la escala de ENGEL en el servicio Neurocirugía del Hospital Materno Infantil de la Caja Nacional de Salud La Paz Bolivia del 2008 al 2011. Se ha demostrado que el 69% de los pacientes sometidos a cirugía de epilepsia en nuestro centro son considerados como éxito quirúrgico de acuerdo con la Escala de ENGEL, con una mortalidad de cero y con una mejoría en relación a la morbilidad de la patología de base sin asociar complicaciones postquirúrgicas.

          Translated abstract

          The clinical and epidemiologic concept of epilepsy as a chronic disease recommended by the WHO and ILAE requires the chronic repetition of seizures1,2. Epilepsy is classified into symptomatic, cryptogenic and idiopática1. It reported that about 1% of the world's population has epilepsy, being a very common disease of great interest in public health, so the possibility of a cure or significant improvement with surgical treatment is a field of research is constantly growing. It is known that the surgical procedure should be performed in patients with symptomatic epilepsy represent 40 to 60% of cases. Patients with refractory epilepsy are 10% and these are the candidates for surgical treatment of Functional Neurosurgery, obtaining a favorable outcome in more than 60% of patients operados1,2,3,4,5,6,7. The present work aims to determine the recurrence of epileptic Crisis Associated surgical treatment of epilepsy according to the scale of ENGEL in Neurosurgery Service of the Maternity Hospital National Health La Paz Bolivia from 2008 to 2011. It has been shown that 69% of patients undergoing epilepsy surgery at our center are considered surgical success according to the scale ENGEL, with a mortality of zero and an improvement in relation to the morbidity of the underlying disease with no associated postoperative complications.

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          Most cited references 23

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          Handbook of Neurosurgery

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            Microsurgical anatomy of the temporal lobe: part 1: mesial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy.

            We review the anatomy of the mesial temporal lobe region, establishing the relationships among the intraventricular, extraventricular, and surrounding vascular structures and their angiographic characterization. We also demonstrate the clinical application of these anatomic landmarks in an anatomic temporal lobectomy plus amygdalohippocampectomy. Fifty-two adult cadaveric hemispheres and 12 adult cadaveric heads were studied, using a magnification ranging from 3x to 40x, after perfusion of the arteries and veins with colored latex. The intraventricular elements are the hippocampus, fimbria, amygdala, and choroidal fissure; the extraventricular elements are the uncus and parahippocampal and dentate gyri. The uncus has an anterior segment, an apex, and a posterior segment that has an inferior and a posteromedial surface; the uncus is related medially to cisternal elements and laterally to intraventricular elements. The anterior segment is related to the proximal sylvian fissure, internal carotid artery, proximal M1 segment of the middle cerebral artery, proximal cisternal anterior choroidal artery, and amygdala. The apex is related to the oculomotor nerve, uncal recess, and amygdala; the posteromedial surface is related to the P2A segment of the posterior cerebral artery inferiorly, to the distal cisternal anterior choroidal artery superiorly, and to the head of the hippocampus and amygdala intraventricularly. The choroidal fissure is located between the thalamus and fimbria; it begins at the inferior choroidal point behind the head of the hippocampus and constitutes the medial wall of the posterior two-thirds of the temporal horn. Not only is the knowledge of these relations useful to angiographically characterize the mesial temporal region, but it has also proven to be of extreme value during microsurgeries involving this region.
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              The Cerebrum

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rmcmlp
                Revista Médica La Paz
                Rev. Méd. La Paz
                Colegio Médico de La Paz (La Paz, , Bolivia )
                1726-8958
                2014
                : 20
                : 2
                : 15-22
                Affiliations
                La Paz orgnameC.N.S. orgdiv1Servicio de Neurocirugía dr.jorge.jimenez.torres@ 123456gmail.com
                Article
                S1726-89582014000200004

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 8
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