Which patients are good candidates for epilepsy surgery?
Epilepsy surgery is effective in well-selected patients with pharmacoresistant focal epilepsy.
Surgical resection can result in seizure freedom in approximately 80% of patients with seizures due to a structural lesion (e.g., cavernous angioma or low-grade neoplasm), 60% to 70% of patients with temporal lobe epilepsy, and 50% of patients with focal extratemporal epilepsy.
Palliative epilepsy surgery may be performed when focal resection is not feasible and includes disconnections/neuroablation procedures (e.g., corpus callosotomy and hemispherotomy), and neuromodulation with implantable devices (e.g., vagus nerve stimulation and responsive neurostimulation).
