Skip Navigation LinksHome > June 2013 - Volume 19 - Issue 3, Epilepsy > Surgical Treatment of Epilepsy
CONTINUUM: Lifelong Learning in Neurology:
doi: 10.1212/01.CON.0000431398.69594.97
Review Articles

Surgical Treatment of Epilepsy

Miller, John W. MD, PhD; Hakimian, Shahin MA, MD

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Abstract

Purpose of Review: This article outlines indications for neurosurgical treatment of epilepsy, describes the presurgical workup, summarizes surgical approaches, and details expected risks and benefits.

Recent Findings: There is class I evidence for the efficacy of temporal lobectomy in treating intractable seizures, and accumulating documentation that successful surgical treatment reverses much of the disability, morbidity, and excess mortality of chronic epilepsy.

Summary: Chronic, uncontrolled focal epilepsy causes progressive disability and increased mortality, but these can be reversed with seizure control. Vigorous efforts to stop seizures are warranted. If two well-chosen and tolerated medication trials do not achieve seizure control, an early workup for epilepsy surgery should be arranged. If this workup definitively identifies the brain region from which the seizures arise, and this region can be removed with a low risk of disabling neurologic deficits, neurosurgery will have a much better chance of stopping seizures than further medication trials.

© 2013 American Academy of Neurology

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