Patients with drug-resistant epilepsy should undergo comprehensive pre-operative evaluation for epilepsy surgery, which achieves seizure remission in approximately 65% of cases at 5 years.
Standardizes pre-operative evaluations to improve epilepsy surgery outcomes; reinforces Level 1 guidance for drug-resistant cases.
Epilepsy surgery is an approved treatment for the management of drug-resistant epilepsy or refractory epilepsy (RE). Approximately one-third of patients with epilepsy will develop RE. RE is considered a serious public health threat carrying important biopsychosocial consequences including seizure-related accidents, professional limitations, and increased risk of sudden death. Epilepsy surgery is associated with seizure remission in approximately 65% of patients after a 5 year follow-up. Patients with drug-resistant epilepsy should be referred to a specialized center for a pre-operative evaluation. Pre-operative evaluation requires at least a detailed clinical analysis, an electroencephalogram (EEG) and video-EEG, a cranial magnetic resonance imaging test, as well as neuropsychological, developmental, and psychiatric evaluations. The most common surgical procedures are temporal lobe resections, extratemporal and multilobar resections, lesionectomy, hemispherectomies, callosotomies, and multiple subpial transections, in descending order of frequency.
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Ruíz-Garcìa et al. (2019) studied this question.
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