Novel surgical therapies for epilepsy.

BACKGROUND Despite advances in antiepileptic drug (AED) development, only 50 to 70% of epileptic patients are controlled with pharmacotherapy. With a point prevalence of 0.5 to 1.0% of the United States population afflicted with epilepsy, there are estimated to be hundreds of thousands of epileptics who are not seizure free on medical therapy. At least one-third of these patients are likely candidates for epilepsy surgery.4 However, as shown in Figure 17.1, there is great variability in the percentage of patients rendered seizure free for different surgical pathologies and procedures. A clinical need exists for novel epilepsy treatments. Table 17.1 outlines novel surgical therapies for epilepsy that are under investigation now or may be available in the near future. Complete discussion of all of these is beyond the scope of this presentation. The therapies marked with an asterisk will be highlighted.