title: [Epilepsy surgery--assessment and patient selection].
abstract: BACKGROUND
  Considerable progress in diagnostic imaging and video EEG monitoring has improved the possibilities of localising the epileptogenic zone of the brain in patients with epilepsy. Despite the fact that epilepsy surgery can therefore be offered to more patients today than previously, relatively few patients are referred for an assessment for surgery. The aim of this review is to provide a brief account of the patient selection procedures and the investigations prior to epilepsy surgery.
  
  
  METHODS
  The review is based on a literature search in PubMed and the personal experiences of the authors in this field.
  
  
  RESULTS
  If the epilepsy does not respond to any kind of pharmacological treatment, and idiopathic generalised epilepsy and pseudoresistance have been ruled out, the patient should be evaluated for surgery. The evaluation is multidisciplinary, and the aim is to localise the epileptogenic zone, which can be identified by both structural and functional abnormalities. It must be determined before the operation whether the zone can be removed without leaving severe neurological or cognitive impairment. The best results after epilepsy surgery are seen in patients with a morphological substrate, particularly temporal lobe epilepsy associated with hippocampal sclerosis.
  
  
  CONCLUSIONS
  Epilepsy surgery plays an ever more important role in the treatment of patients with drug resistant seizures. Doctors who treat epileptic patients should refer candidates for surgery at an early stage of the disease.
authors.affiliation: Avdeling for kompleks epilepsi-SSE, Klinikk for kirurgi og nevrofag, Oslo universitetssykehus, Norway. karl.otto.nakken@ous-hf.no
authors.forename: Karl O
authors.initials: KO
authors.lastname: Nakken
authors.forename: Hrisimir
authors.initials: H
authors.lastname: Kostov
authors.forename: Anette
authors.initials: A
authors.lastname: Ramm-Pettersen
authors.forename: Einar
authors.initials: E
authors.lastname: Heminghyt
authors.forename: Søren Jacob
authors.initials: SJ
authors.lastname: Bakke
authors.forename: Bård
authors.initials: B
authors.lastname: Nedregaard
authors.forename: Arild
authors.initials: A
authors.lastname: Egge
mesh_terms: D001921:Brain / Q000503:physiopathology / Q000601:surgery*; D001931:Brain Mapping / Q000379:methods; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D018579:Patient Selection; D016896:Treatment Outcome