Making the Decision

In trying to decide whether an individual patient is likely to benefit from surgery, the medical team will want to know:

• Is the problem really epilepsy?
  Up to 25 percent of adults presenting with uncontrollable seizures at one epilepsy center were, in fact, suffering from paroxysmal episodes not produced by excessive electrical discharge in the brain.
• Is this the type of seizure that can be helped by an operation?
  Although the number of techniques now in use, routinely or experimentally, has increased the number of people who may benefit from surgery, surgery is still limited to certain types of seizures.
• Have there been sufficient efforts to control the seizures with drugs or, in the case of young children, with drugs and diet?
• Might the condition get better without surgery?
• Might it get worse without surgery?
• Do the benefits outweigh the risks?

Answers to these questions come from a variety of sources — the medical history of the patient or the patient's family; physical examinations; medical records; and a battery of pre-surgical tests.