Vinko V. Dolenc – författare

This is the latest in this already classic series that presents recent progress and detailed descriptions of standard procedures, to assist young neurosurgeons in their post-graduate training. It comes with contributions from experienced European and American clinicians.

This series, sponsored by the European Association of Neurosurgical Societies, has already become a classic. In general, one volume is published per year. The Advances section presents fields of neurosurgery and related areas in which important recent progress has been made. The Technical Standards section features detailed descriptions of standard procedures to assist young neurosurgeons in their post-graduate training. The contributions are written by experienced clinicians and are reviewed by all members of the Editorial Board.

20 years ago Professor Dolenc edited the first comprehensive and up-to-date text dealing with the cavernous sinus and addressing anyone concerned with the diagnosis and treatment of lesions of the skull base. Now, he has edited a new volume with articles by specialists in this topic presenting the state of the art in this technology.

This series has already become a classic. In general, one volume is published per year. The advances section presents fields of neurosurgery and related areas in which important recent progress has been made. The technical standards section features detailed descriptions of standard procedures to assist young neurosurgeons in their post-graduate training. The contributions are written by experienced clinicians and are reviewed by all members of the editorial board.

Advances and Technical Standards in Neurosurgery was conceived in 1972byitsfoundingfathersJeanBrihaye,BernardPertuiset,FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR.KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke's Hospital,UniversityofCambridge,Cambridge,UK Abstract...61 Introduction...62 Surgicaltechnique...67 Cranialexposure...69 Cervicalexposure...70 Saphenousveinexposure...71 Preauriculartunnel...72 Contents IX Anastamoses...73 Distalanastamosis...73 Externalcarotidanastamosis...74 Closureandpostoperativecare...77 Discussion...77 Comparisonofoutcomes...77 Choosingthetypeofgraft...78 Longtermpatencyofgrafts...79 Ischaemiccomplications...79 Anticoagulationrelatedmorbidity...81 Conclusion...

The atlas covers the normal microsurgical anatomy of the central skull base as well as the pathological anatomy of the tumorous and vascular lesions of this region. The book gives a detailed description of the contemporary approaches to the individual pathologies in the central skull base which have evolved in the last 15 years and represent the summary of the experience gained by the author through continuous neuroanatomy laboratory work as well as in performing over 1500 operations in the region. Complete or partial resection of the tumorous lesions, the exclusion of aneurysms and preservation of the patency of the internal carotid artery will be presented as well as the cost-benefit ratios of these direct surgical approaches to the central skull base. The large number of operations is a very valuable and unique source of technical data and statistics and allows a careful evaluation of the approaches to the region based on a precise understanding of the underlying anatomy.

The latest in this already classic series presents recent progress and detailed descriptions of standard procedures, to assist young neurosurgeons in their post-graduate training. With contributions from experienced European and American clinicians.

Targeted at clinicians and residents, this series has already become a classic, with one volume published each year. The Advances section presents fields of neurosurgery and related areas in which important recent progress has been made. The Technical Standards section features detailed descriptions of standard procedures to assist young neurosurgeons in their post-graduate training. The contributions have been written by experienced clinicians and are reviewed by all members of the editorial board.

20 years ago Professor Dolenc edited the first comprehensive and up-to-date text dealing with the cavernous sinus and addressing anyone concerned with the diagnosis and treatment of lesions of the skull base. Now, he has edited a new volume with articles by specialists in this topic presenting the state of the art in this technology.

Advances and Technical Standards in Neurosurgery was conceived in 1972byitsfoundingfathersJeanBrihaye,BernardPertuiset,FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR.KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke' andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties.Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 EURO Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke' andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace.Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...28 EURO Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke's Hospital,UniversityofCambridge,Cambridge,UK Abstract...61 Introduction...62 Surgicaltechnique...67 Cranialexposure...69 Cervicalexposure...70 Saphenousveinexposure...71 Preauriculartunnel...72 Contents IX Anastamoses...73 Distalanastamosis...73 Externalcarotidanastamosis...74 Closureandpostoperativecare...77 Discussion...77 Comparisonofoutcomes...77 Choosingthetypeofgraft...78 Longtermpatencyofgrafts...79 Ischaemiccomplications...79 Anticoagulationrelatedmorbidity...81 Conclusion...

Detecting residual cognitive function in disorders of consciousness (M. R. COLEMAN,  J. D. PICKARD).- Rationale for hypothalamus-deep brain stimulation in food intake disorders and obesity (N. TORRES, S. CHABARDEES, A. L. BENABID).- Gustatory and reward brain circuits in the control of food intake (A. J. OLIVEIRA-MAIA, C. D. ROBERTS, S. A. SIMON, M. A. L. NICOLELIS).- SEEG-guided RF-thermocoagulation of epileptic foci: A therapeutic alternative for drug-resistant non-operable partial epilepsies (M. GUÉNOT, J. ISNARD, H. CATENOIX, F. MAUGUIERE,  M. SINDOU).- Child abuse – some aspects for neurosurgeons (B. MADEA, M. NOEKER, I. FRANKE.- Prophylactic antibiotics and anticonvulsants in neurosurgery (B. RATILAL, C. SAMPAIO).- The dural sheath of the optic nerve: descriptive anatomy and surgical applications (P. FRANCOIS,  E. LESCANNE, S. VELUT) -Surgical indications and techniques for failed coiled aneurysms (C. RAFTOPOULOS; with the collaboration of G. VAZ).

AdvancesJ. Maarrawi, P. Mertens, R. Peyron, L. Garcia-Larrea, M. Sindou: Functional exploration for neuropathic pain. - Z. H. Rappaport: The neuroscientific foundations of free will. - A. Hejcl, P. Jendelova, E. Sykova: Experimental reconstruction of the injured spinal cord. - M. Visocchi: Advances in video-assisted anterior surgical approach to the craniovertebral junction. Technical StandardsN. Akalan: Myelomeningocele (Open spina bifida): Surgical management. - M. Stoffel, C. Stüer, F. Ringel, B. Meyer: Treatment of infections of the spine. - I. Massimi, F. Novegno, C. di Rocco: Chiari Type 1 malformation in children.

Advances: H. Duffau: Subpial dissection and subcortical mapping with vasculature and white matter pathways preservation in surgery for brain (low grade) gliomas. - F. Scholtes, G. Brook, D. Martin: Spinal cord injury and its treatment: current management and experimental perspectives. - M. Sindou, M. Messerer, J. Alvernia, G. Saint-Pierre: Percutaneous Biopsy through the Foramen Ovale for Parasellar lesions: Surgical anatomy, Method and Indications. - Technical Standards: C. Raftopoulos, F. Waterkeyn, E. Fomekong, T. Duprez: Percutaneous pedicle screw implantation with robotic intraoperative 2D/3D fluoroscopy for refractory low back pain. – I. Zemmoura, S. Velut, P. Francois:The choroidal fissure: anatomy and surgical implications. – I. Timofeev, T. Santarius, A.G. Kolias, P.J.A. Hutchinson: Decompressive craniectomy – operative technique and perioperative care. - S Fauser, J Zentner: Management of complex cortical dysplasia in epilepsy

Detecting residual cognitive function in disorders of consciousness (M. R. COLEMAN,  J. D. PICKARD).- Rationale for hypothalamus-deep brain stimulation in food intake disorders and obesity (N. TORRES, S. CHABARDEES, A. L. BENABID).- Gustatory and reward brain circuits in the control of food intake (A. J. OLIVEIRA-MAIA, C. D. ROBERTS, S. A. SIMON, M. A. L. NICOLELIS).- SEEG-guided RF-thermocoagulation of epileptic foci: A therapeutic alternative for drug-resistant non-operable partial epilepsies (M. GUÉNOT, J. ISNARD, H. CATENOIX, F. MAUGUIERE,  M. SINDOU).- Child abuse – some aspects for neurosurgeons (B. MADEA, M. NOEKER, I. FRANKE.- Prophylactic antibiotics and anticonvulsants in neurosurgery (B. RATILAL, C. SAMPAIO).- The dural sheath of the optic nerve: descriptive anatomy and surgical applications (P. FRANCOIS,  E. LESCANNE, S. VELUT) -Surgical indications and techniques for failed coiled aneurysms (C. RAFTOPOULOS; with the collaboration of G. VAZ).

AdvancesJ. Maarrawi, P. Mertens, R. Peyron, L. Garcia-Larrea, M. Sindou: Functional exploration for neuropathic pain. - Z. H. Rappaport: The neuroscientific foundations of free will. - A. Hejcl, P. Jendelova, E. Sykova: Experimental reconstruction of the injured spinal cord. - M. Visocchi: Advances in video-assisted anterior surgical approach to the craniovertebral junction. Technical StandardsN. Akalan: Myelomeningocele (Open spina bifida): Surgical management. - M. Stoffel, C. Stüer, F. Ringel, B. Meyer: Treatment of infections of the spine. - I. Massimi, F. Novegno, C. di Rocco: Chiari Type 1 malformation in children.

Advances: H. Duffau: Subpial dissection and subcortical mapping with vasculature and white matter pathways preservation in surgery for brain (low grade) gliomas. - F. Scholtes, G. Brook, D. Martin: Spinal cord injury and its treatment: current management and experimental perspectives. - M. Sindou, M. Messerer, J. Alvernia, G. Saint-Pierre: Percutaneous Biopsy through the Foramen Ovale for Parasellar lesions: Surgical anatomy, Method and Indications. - Technical Standards: C. Raftopoulos, F. Waterkeyn, E. Fomekong, T. Duprez: Percutaneous pedicle screw implantation with robotic intraoperative 2D/3D fluoroscopy for refractory low back pain. – I. Zemmoura, S. Velut, P. Francois:The choroidal fissure: anatomy and surgical implications. – I. Timofeev, T. Santarius, A.G. Kolias, P.J.A. Hutchinson: Decompressive craniectomy – operative technique and perioperative care. - S Fauser, J Zentner: Management of complex cortical dysplasia in epilepsy