Epilepsy Surgery Publications

Nearly one-third of people living with epilepsy have uncontrolled seizures despite taking seizure medications. In some cases, surgery is the only remaining and best option for treatment. When the seizure focus can be clearly identified, surgery can be potentially curative. We are actively studying how to improve epilepsy surgery in terms of its safety and effectiveness.

Here are some examples of our pioneering efforts:

1. The effect of seizure surgery completely depends on successful localization of the seizure focus. We use state of the art methods to noninvasively localize seizures. For example, UCSF Medical Center is the only center in Northern California offering magnetoencephalography (MEG), which us a powerful imaging tool for localizing seizure networks in the brain. We are referred patients from throughout the West Coast for this service.

When necessary, we use diagnostic procedures such as implanted intracranial electrodes to further localize the seizure onsets.  In addition to standard grid electrodes, we are one of the first medical centers in the United States to use stereoencephalography (sEEG) for localization. It is a minimally invasive approach that is designed to precisely pinpoint the seizure onset zone. 

2. We are leading the development of minimally invasive approaches to epilepsy surgery.  We specialize in the new treatments such as"laser" ablation, and radiosurgery for epilepsy.  See Contra Costa Times article. UCSF is the lead coordinating study center for the international NIH-funded trial on stereotactic radio surgery (ROSE trial), which promise to treat focal epilepsy as an outpatient procedure.

When minimally invasive surgery is not an option, we specialize in tailored surgeries that are guided by experienced brain mapping to identify and protect critical brain regions.

Our publications related to improving seizure surgery outcomes and methods for safer brain mapping are here:

Unsupervised Learning of Spatiotemporal Interictal Discharges in Focal Epilepsy.

Baud MO, Kleen JK, Anumanchipalli GK, Hamilton LS, Yee-Leng T, Knowlton R, Chang EF.

Neurosurgery. 2017 Oct 10. (epub)

Epilepsy and brain tumors.

Englot DJ, Chang EF, Vecht CJ.

Handb.Clin.Neurol. 2016, 134, 267-285.

Epilepsy with temporal encephalocele: Characteristics of electrocorticography and surgical outcome.

Panov F, Li Y, Chang EF, Knowlton R, Cornes SB.

Epilepsia. 2016, 57, 2, e33-8.

Major and minor complications in extraoperative electrocorticography: A review of a national database.

Rolston JD, Englot DJ, Cornes S, Chang EF.

Epilepsy Res. 2016, 122, 26-29.

Surgical management of medically refractory epilepsy in patients with polymicrogyria.

Wang DD, Knox R, Rolston JD, Englot DJ, Barkovich AJ, Tihan T, Auguste KI, Knowlton RC, Cornes SB, Chang EF.

Epilepsia. 2016, 57, 1, 151-161.

Minimally invasive epilepsy surgery.

Zaghloul KA, Chang EF.

Neurosurg.Clin.N.Am. 2015, 27, 1, xiii-xiv.

A probabilistic map of the human ventral sensorimotor cortex using electrical stimulation.

Breshears JD, Molinaro AM, Chang EF

Journal of Neurosurgery. 2015 May 15. (epub)

Minially invasive surgical approaches for temporal lobe epilepsy.

Chang EF, Englot DJ, Vadera S

Epilepsy Behav. 2015, 47, 24-33.

Global and regional functional connectivity maps of neural oscillations in focal epilepsy.

Englot DJ, Hinkley LB, Kort NS, Imber BS, Mizuiri D, Honma SM, Findlay AM, Garrett C, Cheung PL, Mantle M, Tarapore PE, Knowlton RC, Chang EF, Kirsch HE, Nagarajan SS

Brain. 2015, 138, Pt 8, 2249-2262.

Epileptogenic zone localization using magnetoencephalography predicts seizure freedom in epilepsy surgery.

Englot DJ, Nagarajan, SS, Imber BS, Raygor KP, Honma SM, Mizuiri D, Mantle M, Knowlton RC, Kirsch HE, Chang EF

Epilepsia. 2015, 56, 6, 949-958.

Rates and predictors of seizure freedom with vagus nerve stimulation for intractable epilepsy.

Englot DJ, Rolston JD, Wright CW, Hassnain KH, Chang EF

Neurosurgery. 2015.

Rates and predictors of seizure freedom in resective epilepsy surgery: an update. 

Englot DJ & Chang EF

Neurosurg Rev. 2014 Jul;37(3):389-404; discussion 404-5.

Epilepsy surgery failure in children: a quantitative and qualitative analysis.

Englot DJ, Han SJ, Rolston JD, Ivan ME, Kuperman RA, Chang EF, Gupta N, Sullivan JE, Auguste KI. 

J Neurosurg Pediatr. 2014 Oct;14(4):386-95.

Factors associated with failed focal neocortical epilepsy surgery.

Englot DJ, Raygor KP, Molinaro AM, Garcia PA, Knowlton RC, Auguste KI, Chang EF.

Neurosurgery. 2014 Aug 19. (epub)

Relationship between hospital surgical volume, lobectomy rates, and adverse perioperative events at U.S. Epilepsy Centers.

Englot DJ, Ouyang D, Wang DD, Rolston JD, Garcia PA, Chang EF
Journal of Neurosurgery. 2013 Jan;118(1):169-74.

Transmantle sign in cortical dysplasia: a unique radiologic entity with excellent prognosis for seizure-control.

Wang DD, Deans A, Barkovich AJ, Tihan T, Garcia PA, Barbaro NM, Chang EF

Journal of Neurosurgery. 2013 Feb;118(2):337-44.

Safety and efficacy of motor mapping utlizing short pulse-train direct cortical stimulation.

Tate MC, Guo LJ, McEvoy J, Chang EF

Stereotactic and Functional Neurosurgery. 2013;91(6):379-85.

Seizure outcomes after temporal lobectomy in pediatric patients: A systematic review and meta-analysis.

Englot DJ, Rolston JD, Wang DD, Sun P, Chang EF, Auguste KI

Journal of Neurosurgery: Pediatrics. 2013 Aug;12(2):134-41.

Visual field defects after radiosurgery for mesial temporal lobe epilepsy.

Hensley-Judge H, Quigg M, Barbaro NM, Newman SA, Ward MM, Chang EF, Broshek DK, Lamborn KR, Laxer KD, Garcia P, Heck CN, Kondziolka D, Beach R, Salanova V, Goodman R

Epilepsia. 2013 Aug;54(8):1376-80.

Effects of temporal lobectomy on consciousness-impairing and consciousness-sparing seizures in children.

Englot DJ, Rutkowski MJ, Ivan ME, Sun PP, Kuperman RA, Chang EF, Gupta N, Sullivan JE, Auguste KI

Childs Nerv Syst. 2013 Oct;29(10):1915-22.

Seizure outcomes after temporal lobectomy in pediatric patients.

Englot DJ, Rolston JD, Wang DD, Sun PP, Chang EF, Auguste KI

J Neurosurg Pediatr. 2013 Aug;12(2):134-41.

Seizure outcomes after resective surgery for extra-temporal lobe epilepsy in pediatric patients.

Englot DJ, Breshears JD, Sun PP, Chang EF, Auguste KI.

J Neurosurg Pediatr. 2013 2013 Aug;12(2):126-33

Seizure types and frequency in patients who “fail” temporal lobectomy for intractable epilepsy. 

Englot DJ, Lee AT, Tsai C, Halabi C, Barbaro NM, Auguste KI, Garcia PA, Chang EF

Neurosurgery. 2013 Nov;73(5):838-44.

Extent of surgical resection predicts seizure freedom in low-grade temporal lobe brain tumors.

Englot DJ, Berger MS, Barbaro NM, Chang EF

Neurosurgery. 2012 Apr;70(4):921-8.

Factors associated with seizure freedom in the surgical resection of glioneuronal tumors.

Englot DJ, Berger MS, Barbaro NM, Chang EF

Epilepsia. 2012 Jan;53(1):51-7.

Epilepsy surgery trends in United States, 1990-2008.

Englot DJ, Ouyang D, Barbaro NM, Garcia PA, Chang EF

Neurology. 2012 Apr;17;78(16):1200-6.

Rates and predictors of long-term seizure freedom after frontal lobe epilepsy surgery: a systematic review and meta-analysis.

Englot DJ, Wang DD, Rolston J, Shih T, Chang EF

Journal of Neurosurgery. 2012 May;116(5):1042-8.

Comparison of seizure control outcomes and safety of vagus nerve, deep brain, and responsive neurostimulation: evidence from randomized controlled trials.

Rolston JD, Englot DJ, Wang DD, Shih T, Chang EF

Neurosurgical Focus. 2012 Mar;32(3)E14.

A meta-analysis of predictors of seizure freedom in the surgical management of focal cortical dysplasia.

Rowland NC, Englot DJ, Cage T, Sughrue ME, Barbaro NM, Chang EF

Journal of Neurosurgery. 2012 May;116(5):1035-41.

Long-term seizure outcomes after resection of gangliogliomas.

Southwell D, Berger MS, Barbaro NB, Chang EF

Neurosurgery. 2012 Jun;70(6):1406-13; discussion 1413-4.

Seizure predictors and control after microsurgical resection of supratentorial arteriovenous malformations in 440 patients.

Englot DJ, Young WL,Han SJ, McCullough CE, Chang EF, Lawton EF

Neurosurgery. 2012 Sep;71(3)572-80.

Efficacy of vagus nerve stimulation in post-traumatic versus non-traumatic epilepsy.

Englot DJ, Wang DD, Rolston JD, Hassnain K, Gordon C, Chang EF

Journal of Neurosurgery. 2012 Nov;117(5):970-7.

Functional mapping-guided resection of low-grade gliomas in eloquent areas of the brain: improvement of long-term survival.

Chang, EF, Clark, A, Smith, JS, Polley, MY, Chang, SM, Barbaro, NM, McDermott, MW, Berger, MS

Journal of Neurosurgery. 2011 Mar; 114(3):566-73. *chosen as best paper in Journal of Neurosurgery for 2011

Homotopic organization of right hemisphere essential language sites in right and bilateral cerebral hemispheric dominance.

Chang EF, Wang DD, Perry DW, Barbaro NM, Berger MS

Journal of Neurosurgery. 2011 Apr; 114(4):893-902.

Early surgical intervention in adult patients with ganglioglioma is associated with improved clinical seizure outcomes.

Yang I, Chang EF, Han SJ, Barry JJ, Fang S Tihan T, Barbaro NM, Parsa AT

Journal of Clinical Neuroscience. 2011 Jan; 18(1):28-33.

Seizure freedom after surgery for malformations of cortical development.

Chang EF, Wang DD, Barkovich AJ, Tihan T, Auguste KI, Sullivan JE, Garcia PA, Barbaro NM

Annals of Neurology. 2011 Jul;70(1):151-62.

Predictors of seizure freedom after surgical resection of supratentorial low-grade gliomas.

Englot DJ, Barbaro NM, Berger MS, Chang EF

Journal of Neurosurgery. 2011 Aug;115(2):240-4.

Vagus nerve stimulation for epilepsy: a systematic review of efficacy and predictors of response.

Englot DJ, Chang EF, Auguste KI

Journal of Neurosurgery. 2011 Dec;115(6):1248-55.

Predictors of seizure-freedom in the surgical treatment of supratentorial cavernous malformations.

Englot DJ, Han SJ, Lawton MT, Chang EF

Journal of Neurosurgery. 2011 Dec;115(6):1169-74.

Predictors of efficacy after stereotactic radiosurgery for medial temporal lobe epilepsy.

Chang, EF, Quigg, M, Oh, MC, Dillon, WP, Ward, MM, Laxer, KD, Broshek, DK, Barbaro, NM

Neurology. 2010 Jan 12; 74(2):165-72. PMCID: PMC2809028

Seizure control outcomes after surgical resection of dysembryoplastic neuroepithelial tumor in 50 patients.

Chang, EF, Christie, C, Garcia, PA, Sullivan, J, Tihan, T, Gupta, N, Berger, MS, Barbaro, NM

Journal of Neurosurgery: Pediatrics. 2010 Jan;5(1):123-130.

Magnetic source imaging for the surgical evaluation of EEG secondary bilateral synchrony in intractable epilepsy.

Chang, EF, Nagarajan, SS, Mantle, M, Barbaro, NM, Kirsch HE

Journal of Neurosurgery. 2009 Dec; 111(6):1248-56. PMCID: PMC3151560

Safety and feasibility of switching from phenytoin to levetiracetam monotherapy for glioma-related seizure control following craniotomy: a randomized phase II pilot study.

Lim, DA, Tarapore, P, Chang, EF, Burt, M, Chakalian, L, Barbaro, NM, Chang, SM, Lamborn, KR, McDermott, MW

Journal of Neurooncology. 2009 Jul; 93(3):349-54. PMCID: PMC2687520

Seizure characteristics and control following surgical resection in 332 patients with low-grade gliomas.

Chang, EF, Potts, M, Keles, GE, Lamborn, KR, Chang, SM, Barbaro, NM, Berger, MS

Journal of Neurosurgery. 2008 Feb; 108 (2): 227-35.

Focal cortical dysplasia: a review of pathological features, genetics, and surgical outcome.

Wang, VY, Chang, EF, Barbaro, NM

Neurosurg Focus. 2006 Jan 15;20(1):E7.

Intraoperative subcortical stimulation mapping during resection of hemispheric gliomas located in or adjacent to the Rolandic cortex and descending motor pathways.

Keles, GE, Lundin, DA, Lamborn, KR, Chang, EF, Ojemann, GA, Berger, MS

Journal of Neurosurgery. 2004 Mar;100(3):369-75.