When should you consider Epilepsy surgery?

Most patients with Epilepsy do not need surgery. About 70% of patients do not have another seizure after they start taking medications.

Most patients with epilepsy do not need surgery to control their seizures.

However, medications are not able to control seizures in about 30% of patients.
In the year 2002, two physicians named Dr. Kwan and Dr. Brodie discovered something very important.

If you have tried two appropriately chosen anti-seizure medications and you have been taking high doses of these medications regularly, then the chance that a third anti-seizure medication will control your seizures is very low. In fact, they calculated it to be only 4%.

It has been more than 10 years since they did their research, and there are many new medications on the market. They have made a significant, but not dramatic, improvement in these numbers.

My pragmatic approach is to try at least 3 different, properly chosen medications before considering epilepsy surgery.

Hence, I generally recommend to my patients that if your seizures do not stop even after trying 3 appropriately chosen medications, then you should think of other methods of treatment.