Intracranial surgical intervention offers the potential to reduce or eliminate seizures in a substantial number of patients with medically intractable epilepsy. Although some patients with epilepsy have a pathologic condition that can be imaged radiographically, this is not a requirement for the patient to be considered a surgical candidate. Evaluation in a comprehensive epilepsy center includes defining the characteristics of the seizures; integrating medical criteria, psychosocial factors, imaging findings, and surgical risks; and weighing these factors against the risks of continued, uncontrolled epilepsy. Several neurosurgical procedures are available to help these patients, including frontal and temporal lobectomy, lesionectomy, subpial transection, and callosotomy.
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