Presurgical assessment for epilepsy surgery is available for children, adolescents and adults. The aim is to clarify if patients with pharmacologically intractable epilepsy may benefit from resective or palliative surgical approaches. For almost 20 years, the epilepsy surgery programme is one of the clinical focuses of the Epilepsy-Center Berlin-Brandenburg.
The multidisciplinary team consists of neurologists specialised in EEG and epilepsy, EEG technicians, neuropsychologist, nurses and social workers. Beyond neurological routine diagnostic procedures and taking of an epilepsy-specific history, the following tools are applied:
Basic diagnostic investigations
- Video-EEG-long-term monitoring with extended number of electrodes
- Magnetic resonance imaging (cMRI)
- Neuropsychological testing
- Assessment of psychosocial condition
Advanced diagnostic investigations
- Interictal (between seizures) and ictal (during seizures) examinations of brain metabolism: PET, SPECT
- High-resolution MRI (3 tesla) and volumetry, relaxometry, voxel-based-morphometry
- Functional MRI for lateralisation of speech and localisation of motor areas
- Wada-test for speech-lateralisation
- Tractography (diffusion tensor imaging) for illustration of visual and motor pathways
- Transcranial magnetic stimulation for localisation of functional motor areas
- Intracranial EEG recording for localisation of brain areas of seizure onset and propagation
- Cortical stimulation via intracranial EEG electrodes for delineation of epileptogenic from eloquent cortical areas
The final decision regarding epilepsy surgery on individual patients is made in our weekly interdisciplinary case conference. Diagnostic and therapeutic surgical procedures are performed by our neurosurgical cooperation partner, the Department of Neurosurgery at the Charité – Universitätsmedizin Berlin (Head: Prof. Dr. med. Peter Vajkoczy). Beyond resective epilepsy surgery we offer neurostimulation approaches such as vagal nerve and deep brain stimulation where applicable.
For long-term stabilisation of surgical outcome, patients are transferred to medical rehabilitation 1-2 weeks after the operation. This takes place in the Department of Medical Rehabilitation for Epilepsy Patients at the Neurological Rehabilitation Clinic in Beelitz-Heilstätten (30 km south of Berlin), that department is co-directed by the Epilepsy-Center Berlin-Brandenburg.
Dr. med. Christoph Dehnicke
Presurgical assessment for epilepsy surgery
PD Dr. med. Julia Onken
Department of Neurosurgery, Charité – Universitätsmedizin Berlin
Tel.: + 49 (0) 30 – 5472 3503
Mon – Fri, 8 a.m. – 4 p.m.
Fax: + 49 (0) 30 – 5472 2951