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Selecting Patients for Epilepsy Surgery

Current Neurology and Neuroscience Reports volume 10, pages 299–307 (2010)Cite this article

Abstract

About one third of patients with focal epilepsy experience seizures despite adequate medical treatment. In this population, successful epilepsy surgery improves life expectancy and health-related quality of life, while reducing health care costs as a result of reduced hospital admissions, emergency department visits, and use of antiepileptic drugs. The effectiveness of epilepsy surgery and low incidence of surgical complications have been established by numerous studies over several decades. The International League Against Epilepsy recently issued a definition of drug-resistant epilepsy for early identification of patients who are unlikely to be treated successfully with medical therapy alone. Potential surgical candidates are identified through a detailed seizure and medical history, physical examination, and the use of video electroencephalography and neuroimaging. A presurgical evaluation should be considered as soon as drug resistance becomes evident.

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Disclosure

Dr. Wehner received a travel stipend from UCB for the 2009 American Epilepsy Society meeting. Dr. Foldvary-Schaefer has received research support and speaking honoraria from GlaxoSmithKline and UCB. No other potential conflicts of interest relevant to this article were reported.

Author information

Affiliations

  1. Cleveland Clinic Neurological Institute, 9500 Euclid Avenue, FA 20, Cleveland, OH, 44195, USA

    Nancy Foldvary-Schaefer

  2. Prasat Neurological Institute, 312 Rajvitee Rajtavee, Bangkok, 10400, Thailand

    Kanjana Unnwongse

  3. Department of Neurology, Phillips-University Marburg, Rudolf-Bultmann-Strasse 8, 35039, Marburg, Germany

    Tim Wehner

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  1. Kanjana Unnwongse
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  2. Tim Wehner
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  3. Nancy Foldvary-Schaefer
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Correspondence to Nancy Foldvary-Schaefer.

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Unnwongse, K., Wehner, T. & Foldvary-Schaefer, N. Selecting Patients for Epilepsy Surgery. Curr Neurol Neurosci Rep 10, 299–307 (2010). https://doi.org/10.1007/s11910-010-0114-6

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  • DOI: https://doi.org/10.1007/s11910-010-0114-6

Keywords

  • Epilepsy surgery
  • Drug-resistant epilepsy
  • Pharmacoresistant epilepsy
  • Medically intractable epilepsy
  • Video EEG
  • Presurgical evaluation
  • Focal epilepsy
  • Seizure semiology
  • Aura
  • MRI
  • Neuropsychology
  • Nuclear imaging