Selection of patients with chronic drug-resistant epilepsy for resective surgery: 5 years' experience

Selection criteria are the key to success in resective surgery for intractable epilepsy. Using such criteria about 50% of patients admitted for assessment are considered unsuitable, half of these for neurophysiological reasons or because there is evidence of more than one area of structural abnormality. Selection for a good result from temporal lobectomy can be judged, both on the proportion of positive pathological lesions in the resected temporal lobes and on a high degree of seizure relief together with a low incidence of side effects. The same holds for other resections. The relationship between these factors is reviewed.