Camillo Negro (1861-1927) and Antonio Carle (1854-1927): Pioneers of non-resective surgical approach to epilepsy treatment

Study Group on the History of Neurology and of the Study Group on Epilepsy of the Italian Neurological Society

Research output: Contribution to journalReview articlepeer-review

Abstract

Epilepsy surgery developed following the clinical and experimental demonstration of the existence of the primary motor cortex in animals and humans. The first epilepsy surgery procedures were mainly performed to treat focal motor (Jacksonian) epilepsy, as the seizure semiology precisely pointed to the contralateral motor cortex (epileptogenic zone), guiding the surgical removal of the visible lesion found in that region. However, mainly in the absence of any visible alteration of brain tissue, the removal of the portion of the cortex supposed to be responsible for the seizures carried the risk of injuring healthy areas of the brain, often resulting in permanent neurological deficits. In 1891, the prominent Italian neurologist Camillo Negro (1861-1927) described a new technique to treat focal epilepsy using galvanic electrical stimulation of the motor cortex to induce selective cortical destruction. The procedure of "cortical electrolysis", initially performed by prof. Antonio Carle (1854-1927), chief surgeon at the Mauriziano Hospital of Turin, aimed at avoiding the risk of hemorrhage and neurological deficits due to the resective surgical procedures, without compromising asepsis. Camillo Negro deserves to be credited as the first to have envisioned a non-resective surgical approach to the treatment of epilepsy, which in its conceptual basis appears nowadays as extraordinarily modern and pioneering. Recent neurosurgical procedures, such as stereoelectroencephalography-guided radiofrequency thermocoagulation and MRI-guided laser-induced interstitial thermal ablation, although based on different technologies, share the same rationale, using minimally invasive epilepsy surgery to reduce tissue disruption and thus morbidity.

Original languageEnglish
Pages (from-to)108360
JournalEpilepsy Behav.
Volume125
DOIs
Publication statusPublished - Dec 2021

Keywords

  • African Americans
  • Electroencephalography
  • Epilepsy/surgery
  • Humans
  • Magnetic Resonance Imaging
  • Stereotaxic Techniques
  • Treatment Outcome

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