[Epilepsy surgery--a superior but underutilized method. Results of an evidence-based Canadian study]

Wiebe and collaborators have conducted a clinical trial in which patients with temporal lobe epilepsy were randomly assigned to surgery or to continued treatment with antiepileptic drugs. At follow-up after one year, 38 percent of patients in the surgery group were completely seizure free compared with 3 percent among the medically treated control patients. The study demonstrates superiority of surgery in the short one-year perspective for selected patients. Swedish register data indicate that epilepsy surgery is underutilized and that patients are referred to assessment for surgery only after several years delay.