Finally, a Randomized, Controlled Trial of Epilepsy Surgery

Abstract

In all of modern medicine, few generally accepted therapeutic interventions are as underutilized as surgical treatment for epileptic seizures. More than 2 million people in the United States have epilepsy, and 400,000 to 600,000 of them have seizures that cannot be controlled by antiepileptic drugs.¹ As many as one quarter to one half of these people are potential candidates for surgical treatment, yet a 1990 survey revealed that only 1500 therapeutic surgical procedures for epilepsy were performed in the United States in that year and that the rate of use of surgery for epilepsy was equally low in other industrialized countries.² Surgical treatment for epilepsy was essentially nonexistent in the developing world 10 years ago,² although it is now offered in some developing countries.³ Even if the rate of surgical treatment had doubled in the past decade, however, it would have had only a small effect on the health care burden imposed by epilepsy.⁴