In refractory temporal lobe epilepsy, consider surgery sooner
Redeepak Lachhwani, MB, BS, MD
Department of Neurology, The Cleveland Clinic
Hans Lüders, MD, PhD
Chairman, Department of Neurology, The Cleveland Clinic
Address: Deepak Lachhwani, MD, Department of Neurology, S51, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195
ABSTRACTDespite evidence that surgery for temporal lobe epilepsy is safe and effective, physicians continue to view it as a last resort in people who do not respond to medical therapy. A randomized study in Canada has demonstrated significantly higher rates of freedom from seizures in patients who underwent surgery rather than medical therapy. If we wait too long to rule a patient's epilepsy medically refractory, we increase the patient's risk of morbidity and death, and we miss a window of opportunity to eliminate seizures and permit the patient a full and productive life.