# Epilepsy — GCMD Library living collection

Everything in the library about epilepsy — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 39 cited statements

## Episodes
### Fundamentals
- [Epilepsy Surgery Outcomes Explained 🧠](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625) — video · 2:16 · [machine version](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625.md)

### Surgical Management
- [Endoscopic Approaches to Pediatric Epilepsy Surgery: Pediatric Endoscopic...](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385) — video · 23:38 · [machine version](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385.md)

### Case-Based Learning
- [Epilepsy Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics - part 1 out 3](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622) — video · [machine version](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=0) Introduction of Dr. Sandy Lamb (Ep 1)
- [0:34](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=34) Background on Pediatric Epilepsy Surgery and Minimally Invasive Approaches (Ep 1)
- [4:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=280) Cost Analysis and Limitations of Laser Ablation for Corpus Callosotomy (Ep 1)
- [8:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=520) Development of Endoscopic-Assisted Corpus Callosotomy (Ep 1)
- [12:30](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=750) Operative Video: Corpus Callosotomy Technique (Ep 1)
- [15:00](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=900) Evolution and Development of Endoscopic Hemispherectomy (Ep 1)
- [18:20](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1100) Operative Video and Results: Endoscopic Hemispherectomy (Ep 1)
- [22:27](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1347) Discussion and Closing Remarks (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0) Introduction and Structure (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0) Definitions and Referral Thresholds (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0) Seizure Semiology and Localisation (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0) Named Epilepsy Syndromes (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0) EEG Patterns and Electrode Types (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=0) Historical context and development of the Engel classification (Ep 3)
- [0:36](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=36) The four Engel classes explained (Ep 3)
- [1:37](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=97) Summary and key concept (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Recurrent seizures and long-term anti-epileptic drug therapy have detrimental effects on the developing brain in children." — Sandy Lamb (clinical) [Ep 1 · 0:34](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=34)
- "The International League Against Epilepsy has a consensus for recommending early surgical intervention in pediatric epilepsy when it is safe to do so." — Sandy Lamb (guideline) [Ep 1 · 2:00](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=120)
- "Minimally invasive approaches for epilepsy surgery must achieve complete disconnection and offer outcomes similar to maximally invasive approaches." — Sandy Lamb (clinical) [Ep 1 · 2:30](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=150)
- "At Texas Children's Hospital, Dan Curry has been a pioneer in stereotactic laser ablation for epilepsy surgery." — Sandy Lamb (clinical) [Ep 1 · 3:20](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=200)
- "Cost comparison using national databases showed that minimally invasive laser ablation for hamartomas had lower hospitalization costs compared to open surgery." — Sandy Lamb (epidemiological) [Ep 1 · 4:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=280)
- "In a comparison of approximately 10 corpus callosotomies, laser ablation versus open craniotomy showed no difference in length of stay or discharge destination." — Sandy Lamb (clinical) [Ep 1 · 6:20](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=380)
- "With laser ablation for corpus callosotomy, most children needed to go to rehabilitation, three children needed re-operations, and one had transient hemiparesis." — Sandy Lamb (clinical) [Ep 1 · 7:00](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=420)
- "Laser ablation for corpus callosotomy requires multiple trajectories because the anatomy of the corpus callosum is curved, making it difficult to control straight-line catheters." — Sandy Lamb (clinical) [Ep 1 · 7:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=460)
- "Endoscopic corpus callosotomy has been described in cadaveric studies and clinical series by groups including Matt Smith in Saint Louis." — Sandy Lamb (clinical) [Ep 1 · 8:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=520)
- "The endoscopic-assisted approach for corpus callosotomy uses three hands, similar to transsphenoidal surgery, which reduces the learning curve compared to fully endoscopic techniques." — Sandy Lamb (clinical) [Ep 1 · 9:20](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=560)
- "For endoscopic corpus callosotomy, navigation is performed in real time using a straight endoscope, and the surgical steps include interhemispheric approach, identification of pericallosal arteries and ACAs, and white matter disconnection from rostrum to splenium." — Sandy Lamb (clinical) [Ep 1 · 10:00](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=600)
- "Postoperative DTI imaging was used initially to confirm complete disconnection after endoscopic corpus callosotomy." — Sandy Lamb (clinical) [Ep 1 · 14:10](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=850)
- "Hemispherectomy techniques have evolved over time from anatomical to functional hemispherectomy to functional hemispherotomy, with approaches varying from lateral to paramedian vertical." — Sandy Lamb (clinical) [Ep 1 · 15:00](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=900)
- "Al Cohen described cadaveric studies for endoscopic hemispherectomy using two burr holes (frontal and occipital), with the frontal approach providing a view at the foramen of Monro and the occipital approach into the atrium providing a view of the temporal horn." — Sandy Lamb (clinical) [Ep 1 · 15:50](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=950)
- "Dr. Sood and Dr. Chandra have described small series of endoscopic approaches for both callosotomies and hemispherectomies." — Sandy Lamb (clinical) [Ep 1 · 17:30](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1050)
- "The Texas Children's Hospital team developed a single-burr-hole paramedian vertical approach for endoscopic hemispherectomy, with a fallback plan to convert to open approach or middle temporal gyrus approach if needed." — Sandy Lamb (clinical) [Ep 1 · 16:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1000)
- "In cadaveric studies, the single-burr-hole approach allowed visualization of the corpus callosum, lateral ventricle body, anterior corpus callosum, splenium, choroid plexus, atrium, temporal horn after insular cut, and enabled hippocampectomy." — Sandy Lamb (clinical) [Ep 1 · 18:20](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1100)
- "Case selection is very important when developing new endoscopic techniques, and surgeons must have extensive experience and comfort with open surgeries and be very familiar with the anatomy before attempting to minimize the access corridor." — Sandy Lamb (opinion) [Ep 1 · 19:10](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1150)
- "The first endoscopic hemispherectomy patient at Texas Children's Hospital was a post-stroke epilepsy patient with significant tissue loss, providing good initial conditions for the new technique." — Sandy Lamb (clinical) [Ep 1 · 20:00](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1200)
- "Preliminary results from the small case series show that children undergoing endoscopic hemispherectomy mobilize quicker, have less soft tissue edema, and recover faster than with open craniotomy." — Sandy Lamb (clinical) [Ep 1 · 21:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1300)
- "Anesthesia colleagues did not see the need to transfuse blood during endoscopic hemispherectomy cases, and blood loss was much less than with open craniotomies for hemispherectomies." — Sandy Lamb (clinical) [Ep 1 · 22:10](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1330)
- "Seizure outcomes with endoscopic hemispherectomy have been comparable to open craniotomy so far, though long-term follow-up and more patients are needed." — Sandy Lamb (clinical) [Ep 1 · 22:40](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1360)
- "Operative time for endoscopic hemispherectomy has been comparable to open craniotomy." — Sandy Lamb (clinical) [Ep 1 · 23:10](https://library.globalcastmd.com/watch/endoscopic-approaches-to-pediatric-epilepsy-surgery-pediatric-endoscopic-385?t=1390)
- "Epilepsy surgery is one of the hardest functional topics in the exam" (opinion) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "The best way to understand epilepsy surgery is to follow the structure: Diagnose, Investigate, Operate" (opinion) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Two seizures are required to diagnose epilepsy" (guideline) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Two failed appropriate drugs are required before referring for surgical assessment" (guideline) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Absence epilepsy has a characteristic 3 Hz spike-and-wave pattern on EEG" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Lennox-Gastaut syndrome has a slow 1.5-2.5 Hz spike-and-wave pattern on EEG" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Juvenile myoclonic epilepsy has a 4-6 Hz polyspike-and-wave pattern on EEG" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "West syndrome is characterized by spasms, hypsarrhythmia, and developmental regression" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Hypothalamic hamartoma presents with gelastic seizures and precocious puberty" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Seizure classification includes focal, generalised, and unknown onset types" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Clinical seizure sequence can help localise and lateralise the seizure focus" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Normal posterior alpha rhythm is a recognized EEG pattern" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Frontal beta activity is a recognized EEG pattern" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Hypsarrhythmia is a recognized pathological EEG pattern" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Burst suppression is a recognized pathological EEG pattern" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Depth or stereo EEG and subdural grids are electrode types used in epilepsy evaluation" (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/epilepsy-exam-questions-for-neurosurgeons-mcqs-concepts-and-key-topics-part-1-out-3-13622?t=0)
- "Before the 1980s, surgical outcomes for epilepsy were reported simply as improved or not improved, with every center using its own definition, preventing meaningful comparison of results." (host_summary) [Ep 3 · 0:10](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=10)
- "In 1993, Jerome Engel and colleagues proposed a single standard scale for epilepsy surgery outcomes." (host_summary) [Ep 3 · 0:22](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=22)
- "The Engel classification quickly became the international standard for reporting epilepsy surgery outcomes." (host_summary) [Ep 3 · 0:33](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=33)
- "The Engel classification grades how close the patient is to complete seizure freedom rather than counting seizures." (host_summary) [Ep 3 · 0:37](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=37)
- "Engel Class 1 means the patient is free of disabling seizures and essentially seizure-free — surgery worked." (host_summary) [Ep 3 · 0:54](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=54)
- "Engel Class 2 means rare disabling seizures with long seizure-free stretches — almost seizure-free, surgery worked well but not perfectly." (host_summary) [Ep 3 · 1:01](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=61)
- "Engel Class 3 means worthwhile improvement with seizures still happening but far less than before, where both patient and clinician agree the change was worth it — surgery helped but epilepsy remains active." (host_summary) [Ep 3 · 1:12](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=72)
- "Engel Class 4 means no worthwhile improvement, with seizures continuing at similar frequency or worse — surgery did not achieve meaningful control." (host_summary) [Ep 3 · 1:27](https://library.globalcastmd.com/watch/epilepsy-surgery-outcomes-explained-13625?t=87)

## Changelog
- Sep 25: 3 items added automatically

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