{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:56:07Z","timestamp":1780624567582,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Brain surgery is the only curative treatment for people with focal epilepsy, but it is unclear whether this induces active disease in multiple sclerosis (MS). This creates a barrier to evaluate MS patients for epilepsy surgery. We present two cases of successful epilepsy surgery in patients with pharmacoresistant epilepsy and stable MS and give an overview of the existing literature. (1) a 28\u2010year\u2010old woman with seizures arising from a right basal temporo\u2010occipital ganglioglioma was seizure\u2010free after surgery, without MS relapse but with one new MS lesion postsurgically. (2) a 46\u2010year\u2010old woman with seizures arising from a natalizumab\u2010associated progressive multifocal leukoencephalopathy (PML) lesion in the right frontal lobe was seizure\u2010free after surgery preceded by extraoperative subdural electrocorticography, with new subclinical MS lesions. We are the first to report brain surgery in a PML survivor. Both patients stabilized radiologically after initiating second\u2010line therapies. Successful epilepsy surgery can substantially increase the quality of life in patients with pharmacoresistant epilepsy and MS. With increasing survival rates of brain tumors and PML, the risk\u2013benefit ratio of epilepsy surgery compared to a potential MS relapse after surgery becomes critically important. Shared decision\u2010making is valuable for balancing the risks related to both diseases.<\/jats:p>","DOI":"10.1002\/epd2.20166","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T15:45:38Z","timestamp":1696434338000},"page":"890-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Successful epilepsy surgery in two cases with multiple sclerosis"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6773-985X","authenticated-orcid":false,"given":"Nicole","family":"van Klink","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery Brain Center University Medical Center  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Tousseyn","sequence":"additional","affiliation":[{"name":"Academic Center for Epileptology Maastricht University Medical Center and Kempenhaeghe  Maastricht The Netherlands"},{"name":"School for Mental Health and Neuroscience (MHeNS) University Maastricht (UM)  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Schijns","sequence":"additional","affiliation":[{"name":"Academic Center for Epileptology Maastricht University Medical Center and Kempenhaeghe  Maastricht The Netherlands"},{"name":"School for Mental Health and Neuroscience (MHeNS) University Maastricht (UM)  Maastricht The Netherlands"},{"name":"Department of Neurosurgery Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"van Eijsden","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Brain Center University Medical Center  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Neurology Slingeland hospital  Doetinchem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Hilkman","sequence":"additional","affiliation":[{"name":"Academic Center for Epileptology Maastricht University Medical Center and Kempenhaeghe  Maastricht The Netherlands"},{"name":"Department of Clinical Neurophysiology Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joep","family":"Killestein","sequence":"additional","affiliation":[{"name":"MS Center Amsterdam Amsterdam University Medical Centers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2603-3364","authenticated-orcid":false,"given":"Frans","family":"Leijten","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Brain Center University Medical Center  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01565.x"},{"issue":"3","key":"e_1_2_11_3_1","first-page":"572","article-title":"Cortical lesions in multiple sclerosis: combined postmortem MR imaging and histopathology","volume":"26","author":"Geurts JJG","year":"2005","journal-title":"Am J 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