Mesial Temporal Lobectomy Superior to Medical Therapy for Epilepsy

Epilepsy remains the most prevalent serious neurologic disorder affecting people of all ages. Antiepileptic drugs effectively suppress seizures in about two thirds of patients (see N Engl J Med 2000; 342:314) but do not cure the disorder. Mesial temporal lobectomy may cure or nearly cure complex partial seizures emanating from one of the temporal lobes. Most comprehensive epilepsy centers use this surgery extensively in suitable patients, but the procedure remains markedly underused elsewhere. The reasons for this discrepancy are unclear, but one reason might be the absence, until now, of a properly controlled study demonstrating superiority of surgical over medical management.

This prospective, randomized study comparing mesial temporal lob…