EVALUATING THE OUTCOMES OF EPILEPSY SURGERY

Despite the increasing use and availability of epilepsy surgery, knowledge of its results is still sketchy. Although such surgery certainly produces improvement in seizure control and in patients' psychosocial outcomes as measured by a wide array of techniques and instruments, the exact nature and magnitude of those improvement is unclear. Even less is known about the factors that predict which individuals are most likely to benefit from surgery. This article reviews the available literature on changes in seizure control, psychosocial outcomes, and cognitive function after resective epilepsy surgery. In addition, it outlines deficiencies in the current approaches and discusses promising new approaches. In conclusion, rigorous methods, including the use of clearly defined and meaningful outcome measures, as well as appropriate statistical models such as those used to study other outcomes of seizures or epilepsy, are needed to determine the overall success of surgery and to identify the patients who are most and least likely to have good outcomes. (C) 1994 Wiley-Liss, Inc.