title: Subpial transection surgery for epilepsy.
abstract: BACKGROUND
  Nearly 30% of patients with epilepsy continue to have seizures in spite of using several antiepileptic drug (AED) regimens. Such patients are regarded as having refractory, or uncontrolled, epilepsy. No definition of uncontrolled, or medically refractory, epilepsy has been universally accepted, but for the purposes of this review, we will consider seizures as drug resistant if they have failed to respond to a minimum of two AEDs. It is believed that early surgical intervention may prevent seizures at a younger age, which, in turn, may improve the intellectual and social status of children. Many types of surgery are available for treatment of refractory epilepsy; one such procedure is known as subpial transection.
  
  
  OBJECTIVE
  To determine the benefits and adverse effects of subpial transection for partial-onset seizures and generalised tonic-clonic seizures in children and adults.
  
  
  METHODS
  We searched the Cochrane Epilepsy Group Specialised Register (29 June 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; May 2015, Issue 5) and MEDLINE (1946 to 29 June 2015). We imposed no language restrictions.
  
  
  METHODS
  We considered all randomised and quasi-randomised parallel-group studies, whether blinded or non-blinded.
  
  
  METHODS
  Two review authors (BK and SR) independently screened trials identified by the search. The same two review authors planned to independently assess the methodological quality of studies. When studies were identified for inclusion, one review author would have extracted the data, and the other would have verified the data.
  
  
  RESULTS
  We found no relevant studies.
  
  
  CONCLUSIONS
  We found no evidence to support or refute use of subpial transection surgery for patients with medically refractory epilepsy. Well-designed randomised controlled trials are needed to guide clinical practice.
authors.affiliation: Department of Neurology, Penn State Center, 30 Hope Drive, Hershey, Philadephia, USA, PA 17033.
authors.forename: Balaji
authors.initials: B
authors.lastname: Krishnaiah
authors.forename: Sridharan
authors.initials: S
authors.lastname: Ramaratnam
authors.forename: Lakshmi Narasimhan
authors.initials: LN
authors.lastname: Ranganathan
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000601:surgery*; D004827:Epilepsy / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D009412:Nerve Fibers
chemical_list: D000927:Anticonvulsants