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Surgery for Epilepsy

JAMA. 1990;264(6):729-733. doi:10.1001/jama.1990.03450060075033.
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Epilepsy is common. About 10% of all Americans will have at least one seizure at some time. Many people have one or a few attacks and then never have another one. For those with recurrent seizures, about 70% are satisfactorily controlled with antiepileptic drugs. Of the 150 000 people who develop epilepsy each year, 10% to 20% prove to have "medically intractable epilepsy." Many of these patients and their families have to deal with a chronic disorder that impairs the quality of life for all concerned.

Brain surgery is an alternative treatment if antiepileptic drugs fail, and it is being used more often. Several centers have reported success, and increasing numbers of patients are being referred for surgery, including many children. Improved technology has made it possible to identify more accurately where seizures originate in the brain (epileptic regions), and advances in surgery have made operative management safer. As a result, investigators have estimated


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