Presurgical evaluation and surgical treatment of medically refractory epilepsy

Excerpt

The author has thoroughly reviewed the extensive literature on the diagnostic evaluation and surgical treatment of patients with medically refractory epilepsy. It is certainly correct that epilepsy surgery should not be delayed by administering prolonged medical treatment to patients who could benefit from such surgery. A recent study on temporal lobe epilepsy [11] has proven the superiority of surgery for this type of epilepsy; it should be cited in the author’s long reference list. Wiebe and colleagues reported that the cumulative proportions of patients free of seizures impairing awareness were 58% in the surgical group and 8% in the medical group (P<0.001). Moreover, the surgery patients had fewer such seizures and significantly better quality of life (P<0.001 for both) than patients in the medical group. …