Current status of epilepsy surgery in adults

Epilepsy surgery is an effective way to control seizures in patients with refractory epilepsy, even in patients in whom drug therapy has not resulted in adequate seizure control. Many studies support the efficacy and safety of resective and non-resective surgeries for the treatment of refractory epilepsy in appropriately selected individuals. However, it is sometimes argued that epilepsy surgery is underutilized despite the evidence and guidelines supporting its use. Among the causes cited for underutilization of this treatment are numerous barriers to epilepsy surgery. Further strategies are needed to increase access to surgery and to improve communication about the effectiveness of this potentially life-changing procedure. In addition, epilepsy surgery is only one part of the multimodal treatment of refractory epilepsy. A comprehensive approach is required to address the medical, surgical, psychosocial, rehabilitation and moral needs of patients with epilepsy in order to improve their quality of life.