Surgery for epilepsy

Neurosurgery is now an effective treatment option for some patients with epilepsy

When a seizure disorder persists despite optimum drug therapy and significantly affects quality of life, surgical treatment should be considered. Many patients with severe refractory epilepsy can benefit from appropriate surgery and should be given this option by timely referral and investigation. Extrapolating US studies,1 there are probably several thousand eligible people in Australia. In the past, operations were confined to removal of obvious structural causes of seizure, such as tumours or post-traumatic scars. Over the past 50 years, it has become increasingly apparent that there are many patients with persisting epilepsy who could benefit from surgical resection of foci previously difficult to define. The development of increasingly precise methods of anatomical and functional seizure localisation has expanded this group.