Annals of Neurology

Getting the best outcomes from epilepsy surgery

30 April, 2018

Vejay N. Vakharia MRCS, John S. Duncan FRCP, Juri‐Alexander Witt PhD, Christian E. Elger FRCP, Richard Staba PhD, Jerome Engel PhD Jr

Annals of Neurology 2018; 83:676–690

Neurosurgery is an underutilized treatment that can potentially cure drug‐refractory epilepsy. Careful, multidisciplinary presurgical evaluation is vital for selecting patients and to ensure optimal outcomes. Advances in neuroimaging have improved diagnosis and guided surgical intervention. Invasive electroencephalography allows the evaluation of complex patients who would otherwise not be candidates for neurosurgery. We review the current state of the assessment and selection of patients and consider established and novel surgical procedures and associated outcome data. We aim to dispel myths that may inhibit physicians from referring and patients from considering neurosurgical intervention for drug‐refractory focal epilepsies.