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February 10, 2012

Surgical Options for Epilepsy Glossary of Terms

The following are health and medical definitions of terms that appear in the Surgical Options for Epilepsy article.

Allergic reaction: The hypersensitive response of the immune system of an allergic individual to a substance.
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Anesthesia: Loss of feeling or awareness. A general anesthetic puts the person to sleep. A local anesthetic causes loss of feeling in a part of the body such as a tooth or an area of skin without affecting consciousness. Regional anesthesia numbs a larger part of the body such as a leg or arm, also without affecting consciousness. The term "conduction anesthesia" encompasses both local and regional anesthetic techniques. Many surgical procedures can be done with conduction anesthesia without significant pain. In many situations, such as a C-section, conduction anesthesia is safer and therefore preferable to general anesthesia. However, there are also many types of surgery in which general anesthesia is clearly appropriate.

Anterior: The front, as opposed to the posterior. The anterior surface of the heart is toward the breast bone (the sternum).
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Brain: That part of the central nervous system that is located within the cranium (skull). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."

Brain lesions: an anatomical abnormality of any part of the brain. A brain lesion may be due to trauma or any other disease that can cause inflammation, malfunction, or destruction of a brain cells or brain tissue. A lesion may be localized to one part of the brain or may be widespread. Examples of brain lesions include head injuries, tumors, vascular malformations, damage due to stroke, and damage due to inflammation resulting from infections or chronic diseases.
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Cancer: An abnormal growth of cells which tend to proliferate in an uncontrolled way and, in some cases, to metastasize (spread).
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Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves.
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Corpus: The body of the uterus (womb).

Corpus callosotomy: The corpus callosum is a band of nerve fibers connecting the two halves (hemispheres) of the brain. A corpus callosotomy is an operation in which all or part of this structure is cut, disabling communication between the hemispheres and preventing the spread of seizures from one side of the brain to the other. This procedure, sometimes called split-brain surgery, is for patients with extreme forms of uncontrollable epilepsy who have intense seizures that can lead to violent falls and potentially serious injury.

Cuts: Severed skin. Washing a cut or scrape with soap and water and keeping it clean and dry is all that is required to care for most wounds. Putting alcohol hydrogen peroxide, and iodine into a wound can delay healing and should be avoided. Seek medical care early if you think that you might need stitches. Any delay can increase the rate of wound infection. Any puncture wound through tennis shoes has a high risk of infection and should be seen by your healthcare professional. Any redness, swelling, increased pain, or pus draining from the wound may indicate an infection that requires professional care.

Epilepsy (seizure disorder): When nerve cells in the brain fire electrical impulses at a rate of up to four times higher than normal, this causes a sort of electrical storm in the brain, known as a seizure. A pattern of repeated seizures is referred to as epilepsy. Known causes include head injuries, brain tumors, lead poisoning, maldevelopment of the brain, genetic and infectious illnesses. But in fully half of cases, no cause can be found. Medication controls seizures for the majority of patients.

Frontal: In anatomy, pertaining to the forehead. As, for example, the frontal bone, frontal sinus, and frontal nerve. From the Latin "frons" meaning the forehead or brow.

Functional hemispherectomy: A functional hemispherectomy is a variation of a hemispherectomy, a radical procedure in which one entire hemisphere, or one half of the brain, is removed. With a functional hemispherectomy, one hemisphere is disconnected from the rest of the brain, but only a limited area of brain tissue is removed. This surgery generally is limited to children younger than 13 years old who have one hemisphere that is not functioning normally.

Heart: The muscle that pumps blood received from veins into arteries throughout the body. It is positioned in the chest behind the sternum (breastbone; in front of the trachea, esophagus, and aorta; and above the diaphragm muscle that separates the chest and abdominal cavities. The normal heart is about the size of a closed fist, and weighs about 10.5 ounces. It is cone-shaped, with the point of the cone pointing down to the left. Two-thirds of the heart lies in the left side of the chest with the balance in the right chest.
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Heart disease: Any disorder that affects the heart. Sometimes the term "heart disease" is used narrowly and incorrectly as a synonym for coronary artery disease. Heart disease is synonymous with cardiac disease but not with cardiovascular disease which is any disease of the heart or blood vessels. Among the many types of heart disease, see, for example: Angina; Arrhythmia; Congenital heart disease; Coronary artery disease (CAD); Dilated cardiomyopathy; Heart attack (myocardial infarction); Heart failure; Hypertrophic cardiomyopathy; Mitral regurgitation; Mitral valve prolapse; and Pulmonary stenosis.

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Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment therefrom.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.
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Injury: Harm or hurt. The term "injury" may be applied in medicine to damage inflicted upon oneself as in a hamstring injury or by an external agent on as in a cold injury. The injury may be accidental or deliberate, as with a needlestick injury. The term "injury" may be synonymous (depending on the context) with a wound or with trauma.

Lesion: Pronounced "lee-sion" with the emphasis on the "lee," a lesion can be almost any abnormality involving any tissue or organ due to any disease or any injury.
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Lobe: Part of an organ that appears to be separate in some way from the rest. A lobe may be demarcated from the rest of the organ by a fissure (crack), sulcus (groove), connective tissue or simply by its shape. For example, there are the frontal, parietal, temporal, and occipital lobes of the brain.
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Memory: 1. The ability to recover information about past events or knowledge. 2. The process of recovering information about past events or knowledge. 3. Cognitive reconstruction. The brain engages in a remarkable reshuffling process in an attempt to extract what is general and what is particular about each passing moment.
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Mesial: 1. Toward the middle. As, for example, a mesial temporal lobe structure.
2. In dentistry, toward the middle of the front of the jaw.

MST:: A multiple subpial transection (MST) is a procedure is used to help control seizures that begin in areas of the brain that cannot be safely removed. The surgeon makes a series of shallow cuts (transections) in the brain tissue. These cuts interrupt the movement of seizure impulses but do not disturb normal brain activity, leaving the person's abilities intact.

Multiple subpial transection (MST): A multiple subpial transection (MST) is a procedure is used to help control seizures that begin in areas of the brain that cannot be safely removed. The surgeon makes a series of shallow cuts (transections) in the brain tissue. These cuts interrupt the movement of seizure impulses but do not disturb normal brain activity, leaving the person's abilities intact.

Nerve: A bundle of fibers that uses chemical and electrical signals to transmit sensory and motor information from one body part to another. See: Nervous system.

Neurological: Having to do with the nerves or the nervous system.

Occipital: 1. Pertaining to the occiput, the back of head.
2. Located near the occipital bone as, for example, the occipital lobe of the brain.

Operation: Although there are many meanings to the word "operation", in medicine it refers to a surgical procedure.
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Parietal: Adjective from the Latin "parietalis" meaning "belonging to the wall" that the ancient anatomists used to designate the wall, as of a body cavity.
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Quality of life: An important consideration in medical care, quality of life refers to the patient's ability to enjoy normal life activities. Some medical treatments can seriously impair quality of life without providing appreciable benefit, while others greatly enhance quality of life.

Resection: Surgical removal of part of an organ.

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Seizure: Uncontrolled electrical activity in the brain, which may produce a physical convulsion, minor physical signs, thought disturbances, or a combination of symptoms.
See the entire definition of Seizure

Sensation: In medicine and physiology, sensation refers to the registration of an incoming (afferent) nerve impulse in that part of the brain called the sensorium, which is capable of such perception. Therefore, the awareness of a stimulus as a result of its perception by sensory receptors. (Sensory is here synonymous with sensation.)
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Surgeon: A physician who treats disease, injury, or deformity by operative or manual methods. A medical doctor specialized in the removal of organs, masses and tumors and in doing other procedures using a knife (scalpel). The definition of a "surgeon" has begun to blur in recent years as surgeons have begun to minimize the cutting, employ new technologies that are "minimally invasive," use scopes, etc.
See the entire definition of Surgeon

Surgery: The word "surgery" has multiple meanings. It is the branch of medicine concerned with diseases and conditions which require or are amenable to operative procedures. Surgery is the work done by a surgeon. By analogy, the work of an editor wielding his pen as a scalpel is s form of surgery. A surgery in England (and some other countries) is a physician's or dentist's office.
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Temporal: 1. Pertaining to time, limited in time, temporary, or transient.
2. Pertaining to the temple region of the head. The temporal lobe of the brain is located beneath the temple.
From the Latin tempus which means both time and the temple of the head.

Temporal lobe: The lobe of the cerebral hemisphere located down on the side just forward of the occipital lobe. The temporal lobe contains the auditory cortex which is responsible for hearing. It is also the site of the seizure activity characteristic of temporal-lobe epilepsy.

Temporal lobe epilepsy: See: Epilepsy, temporal-lobe.

Tumor: An abnormal mass of tissue. Tumors are a classic sign of inflammation, and can be benign or malignant (cancerous). There are dozens of different types of tumors. Their names usually reflect the kind of tissue they arise in, and may also tell you something about their shape or how they grow. For example, a medulloblastoma is a tumor that arises from embryonic cells (a blastoma) in the inner part of the brain (the medulla). Diagnosis depends on the type and location of the tumor. Tumor marker tests and imaging may be used; some tumors can be seen (for example, tumors on the exterior of the skin) or felt (palpated with the hands).
See the entire definition of Tumor

Vessel: A tube in the body that carries fluids: blood vessels or lymph vessels.

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Surgical Options for Epilepsy

What Is a Lesionectomy?

A lesionectomy is an operation to remove a lesion -- a damaged or abnormally functioning area -- in the brain. Brain lesions include tumors, scars from a head injury or infection, abnormal blood vessels, and hematomas (a swollen area filled with blood).

A lesion causes seizures -- also called the seizure focus -- in about 20% to 30% of people with epilepsy that do not improve after taking medication (intractable or refractory epilepsy). It is not known for certain if the lesion itself triggers the seizures, or if the seizures result from irritation to the brain tissue surrounding the lesion. For this reason, surgery may also include the removal of a small rim of brain tissue around the lesion, called lesionectomy plus corticectomy.

Who Is a Candidate for Lesionectomy?

Lesionectomy may be an option for people whose epilepsy is linked to a defined lesion and whose seizures are not controlled by medication. I...

Read the Lesionectomy article »







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