27. When Should Epilepsy Neurosurgery Be Considered, and What Can It Accomplish?

  1. John W. Miller MD, PhD Director, UW Regional Epilepsy Center, Professor of Neurology and Neurological Surgery2 and
  2. Howard P. Goodkin MD, PhD The Shure Professor of Neurology and Pediatrics, Director, Division of Pediatric Neurology3
  1. Paul A. Garcia

Published Online: 10 JAN 2014

DOI: 10.1002/9781118456989.ch27



How to Cite

Garcia, P. A. (2014) When Should Epilepsy Neurosurgery Be Considered, and What Can It Accomplish?, in Epilepsy (eds J. W. Miller and H. P. Goodkin), John Wiley & Sons, Oxford. doi: 10.1002/9781118456989.ch27

Editor Information

  1. 2

    University of Washington, Seattle, WA, USA

  2. 3

    Department of Neurology, University of Virginia, Charlottesville, VA, USA

Author Information

  1. Clinical Epilepsy Services, Department of Neurology, University of California San Francisco, San Francisco, CA, USA

Publication History

  1. Published Online: 10 JAN 2014
  2. Published Print: 14 FEB 2014

ISBN Information

Print ISBN: 9781118456941

Online ISBN: 9781118456989



  • epilepsy surgery;
  • epilepsy neurosurgery;
  • anterior temporal lobectomy;
  • vagus nerve stimulator;
  • medically refractory epilepsy


In people with epilepsy, incomplete seizure control is associated with increased mortality and reduced quality of life. When medical treatments have failed to eliminate seizures, surgery can often bring the seizures under control. Evidence-based identification of patients with medically refractory seizures is now possible, allowing prompt referral to a comprehensive epilepsy program. The presurgical evaluation is aimed at minimizing surgical risks and maximizing the chance for seizure control. Successful epilepsy surgery saves lives and lessens the psychosocial impact of chronic seizures.