0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Surgical Treatment for Epilepsy:  Too Little, Too Late?

Jerome Engel, MD, PhD
JAMA. 2008;300(21):2548-2550. doi:10.1001/jama.2008.756.
Text Size: A A A
Published online

Extract

Epilepsy is one of the most common serious neurological conditions. According to a study by the World Health Organization, epilepsy accounts for 1% of the global burden of disease based on disability-adjusted life-years (DALYs), productive years lost due to disability or premature death.1 This is equivalent to lung cancer in men and breast cancer in women. Among primary disorders of the brain, epilepsy ranks with depression and other affective disorders, Alzheimer disease and other dementias, and substance abuse. Of the world's population, 0.5% to 1.0% has active epilepsy, and pharmacotherapy is unsuccessful in controlling seizures in 20% to 40% of patients.2 In the United States, 80% of the cost of epilepsy is attributable to patients with medically intractable seizures.3 Temporal lobe epilepsy is the most common cause of pharmacoresistant seizures4 and may constitute half or more of the patients in the United States with medically intractable epilepsy.5 On the other hand, temporal lobe epilepsy is the form of epilepsy most easily and effectively treated with surgery; 60% to 90% of patients can expect to become free of disabling seizures postoperatively.68 Appropriately applied surgical treatment, therefore, is crucial for reducing the health burden represented by epilepsy.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 32

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();