The neurosurgical treatment of epilepsy

Despite the new advancements in antiepileptic drug development, thousands o f people with epilepsy will remain intractable to medication. For a conside rable proportion of these people, epilepsy surgery is a consideration for b etter control of their seizures. Resective surgery is now standard practice for patients with medication-refractory epilepsy. Temporal lobectomy conti nues to be the most common surgery performed. Once patients fail. 2 to 3 op timal trials of antiepileptic medication, further drug therapy offers a min imal number of patients freedom from seizures. In contrast, temporal lobect omy in carefully selected patients may result in seizure-free outcomes in m ore than 70% to 90% of patients with intractable seizures. As technology an d drug availability increases in the new millennium, it is important for th e primary care physician to be aware of epilepsy surgery as a means to trea t patients with antiepileptic drug-refractory epilepsy.