Update on the surgical treatment of epilepsy

Nathalie Jette, Samuel Wiebe

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations


Purpose of Review: Using the most recent evidence, we provide an update about epilepsy surgery, focusing on the presurgical evaluation and surgical planning, epilepsy surgery outcomes, and utilization. Purpose of Review: Great strides are being achieved in the presurgical evaluation and planning for epilepsy surgery, including fundamental advances in imaging and neurophysiology. A recent randomized controlled trial demonstrates that early surgery for patients with mesial temporal lobe epilepsy (TLE) is superior to medical therapy. The enduring benefits of surgery continue to be demonstrated, particularly after TLE surgery. However, studies examining the long-term outcomes after extratemporal lobe epilepsy surgery are scarce. Surgery is generally associated with an improvement in depression, but mostly in those with good surgical outcome. Complications from invasive monitoring or after epilepsy surgery are generally temporary, or limited in their symptomatology. One area in need of prospective studies is the topic of antiepileptic drug withdrawal after epilepsy surgery (Who? When? How?). Despite its proven effectiveness, epilepsy surgery continues to be underutilized, but new tools for health professionals are emerging to guide appropriate surgical referrals. Summary: Important contributions to the field of epilepsy surgery are discussed, in particular emerging imaging (fMRI) and neurophysiological (high-frequency oscillations) techniques. Epilepsy surgery is effective, well tolerated but still underutilized.

Original languageEnglish
Pages (from-to)201-207
Number of pages7
JournalCurrent Opinion in Neurology
Issue number2
StatePublished - Apr 2013
Externally publishedYes


  • evaluation
  • outcomes
  • referral patterns
  • surgical planning
  • utilization


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