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Surgical treatment of epilepsy. Restoration of personality?


352 epileptic patients were studied by basic science, clinical neurological and psychological teams to assess the effects of epilepsy and its treatment on personality. Those who did not response to well-tried medication were subjected to surgical treatment and short- and long-term follow-up of the results of treatment carried out. The changes in personality following operation and their relationship to the reduction of seizures were recorded. Temporal lobe epilepsy is closely related to personality disorder and the benefits of classical temporal lobectomy on the reduction of seizures and restoration of personality is confirmed. However it is also confirmed that for the best results the earliest referal is necessary i.e. as soon as the failure to respond to adequate therapy is evident. This equally applies to amygdalotomy for violent and destructive behaviour associated with epilepsy particularly in children and also to stereotactic "central" lesions for non-focal intractable epilepsy. The "prefered" pathway for the propagation of the epileptic discharge and its relationship to neurochemical changes occurring during the increased neuronal activity associated with focal motor seizures is described.

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