PRELIMINARY EXPLORATIONS: The advent of magnetic resonance imaging and its capacity to detect fine structural injury and SPECT and PET functional imaging as well as the generalization of EEG-video and the simplification of intracranial electrode implantation techniques has given a whole new life to surgery in epilepsy. Preoperative explorations are shorter and less invasive, allowing surgery without implantation of intracranial electrodes in more than 70% of the cases.
Surgery: New surgical techniques (subpial transection, neuro-navigation...) and improvement in well-known procedures (amygdalo-hippocampectomy...) has made it possible to propose lower risk procedures with minimal trauma (overall complication rate < 10%), particularly for temporal epilepsy where the success rate is greater than 80%.
Fundamental rule: The key to success however directly depends on rigorous application of the fundamental rule of anatomo-electro-clinical correlation.