Early epilepsy surgery.
Uncontrolled epilepsy is associated with progressive cortical and hippocampal atrophy, substantial cognitive and psychosocial morbidity, and increased mortality. Seizure freedom is required to reverse such morbidity and mortality. Surgery is vastly superior to medical therapy for patients with chronic, refractory temporal lobe seizures, and is now the standard of care for these patients. On the other hand, the concept of early surgery requires further exploration and definition. Although there is no robust, direct evidence to support early epilepsy surgery, case series and cohort studies report an association between earlier surgery and better outcomes. The evidence for earlier epilepsy surgery is reviewed.
Wiebe
Samuel
S
London Health Sciences Centre, University Campus, 339 Windermere Road, London, ON N6A 5A5, Canada. swiebe@uwo.ca
D000927:Anticonvulsants / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004827:Epilepsy / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D006801:Humans
D000927:Anticonvulsants