To the Editor: Dr Engel and colleagues1 presented important additional evidence on the superiority of surgical therapy over antiepileptic drugs (AEDs) in the treatment of refractory mesial temporal lobe epilepsy (MTLE). Their results corroborate and expand the findings of a previous randomized controlled trial,2 which led the American Academy of Neurology to issue a practice parameter in 2003 recommending surgery as the treatment of choice for pharmacoresistant MTLE.3
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