Epilepsy surgery

Epilepsy surgery involves a neurosurgical procedure where an area of the brain involved in seizures is either resected, ablated, disconnected or stimulated.^[1] The goal is to eliminate seizures or significantly reduce seizure burden. Approximately 60% of all people with epilepsy (0.4% of the population of industrialized countries) have focal epilepsy syndromes.^[2] In 20% to 30% of these patients, the condition is not adequately controlled with adequate trials of two anticonvulsive drugs, termed drug resistant epilepsy, or refractory epilepsy.^[3][4] Such patients are potential candidates for surgical epilepsy treatment.

First line therapy for epilepsy involves treatment with anticonvulsive drugs, also called antiepileptic drugs– most patients will respond to trials of one or two different medications.^[5] The goal of treatment is the elimination of seizures, since uncontrolled seizures carry significant risks, including injury and sudden unexpected death in epilepsy. In patients with refractory epilepsy, surgery is considered the only curative option.^[3][5][4] Epilepsy surgery has been performed for more than a century, but its use dramatically increased in the 1980s and 1990s, reflecting advancement in technique and improved efficacy in selected patients.^[6][7]