Tactics of Surgical Operations in Patients with Epilepsy

Epilepsy, a chronic neurological disorder characterized by recurrent unprovoked seizures, presents unique challenges for surgical intervention due to potential perioperative seizure activity, pharmacological interactions, and comorbidities. Surgical management may be necessary for both epilepsy-specific procedures, such as resective or palliative epilepsy surgery, and non-neurological surgeries in patients with controlled or uncontrolled seizures. This article examines preoperative evaluation, intraoperative strategies, and postoperative care specifically tailored to patients with epilepsy. Key considerations include optimization of antiepileptic drug therapy, monitoring for seizure triggers, anesthesia selection, and avoidance of perioperative factors that could provoke ictal episodes. Evidence demonstrates that comprehensive planning, multidisciplinary collaboration, and targeted intraoperative management reduce seizure-related complications, improve surgical outcomes, and ensure patient safety. Strategies discussed include seizure monitoring, anesthetic modifications, airway protection, and postoperative pharmacological and supportive care. The integration of neurology, anesthesiology, and surgical teams is essential for achieving optimal results in epileptic patients undergoing surgery. Surgical intervention in patients with epilepsy presents distinct challenges due to the risk of perioperative seizures, potential interactions between anesthetic agents and antiepileptic medications, and comorbid conditions that may complicate operative and postoperative management. This article evaluates strategies to optimize surgical safety, minimize intraoperative seizure occurrence, and ensure favorable recovery outcomes. Key considerations include preoperative stabilization of seizure activity, careful selection and timing of antiepileptic drugs, anesthetic techniques tailored to reduce proconvulsant effects, intraoperative monitoring for subclinical or overt seizures, and postoperative vigilance for seizure recurrence or complications. Evidence indicates that individualized perioperative planning, close collaboration between neurology, anesthesiology, and surgical teams, and patient-specific risk assessment substantially improve procedural safety and reduce morbidity. Effective management enhances both neurological and systemic outcomes, highlighting the importance of targeted surgical tactics for epileptic patients.