The cultivation of epilepsy neurosurgeons: requirements and challenges

Epilepsy surgery has been accepted as an effective treatment in drug-resistant focal epilepsy. However, the number of epilepsy neurosurgeons is not enough in China compared with the huge demand. The content of epilepsy neurosurgeon cultivation includes surgery itself as well as presurgical evaluation. In this article, we review not only different categories of epilepsy surgeries but also the presurgical evaluation approaches including non-invasive methods, such as semiology analysis, high-resolution structural and functional imaging techniques, scalp electroencephalography monitoring as well as invasive methods, such as electrocorticography (ECoG) and stereotactic electroencephalography (SEEG). We also discuss the importance of learning each method briefly. In addition, we suggest that epilepsy neurosurgeons should have a solid structural and functional anatomy basis as it plays pivotal role in localizing epileptogenic zone. Epilepsy neurosurgeons should also be familiar with the staged presurgical evaluation starting from the most preliminary examinations and progressing to more complex and invasive methods. During the diagnosis and therapeutic procedures, collaboration between epilepsy neurosurgeons and other specialists is essential. At last, the necessity of epilepsy neurosurgeon cultivation has been emphasized.