Interpreting Key Trials

In refractory temporal lobe epilepsy, consider surgery sooner

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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.


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