ABSTRACT
The 1990s witnessed an unprecedented release of new antiepileptic drugs (AEDs) for the treatment of epilepsy, a disorder characterized by recurrent seizures that occurs in 0.5-1 % of the population. Nonetheless, a sizable proportion of patients with epilepsy, specifically those whose seizures arise from a focal area of the brain (called partial-onset seizures), have not benefited from new pharmacological treatments and continue to have medically refractory epilepsy (1, 2). Prior to 1997, the available nonpharmacological approaches for such patients included surgical excision of the seizure-generating brain tissue (epilepsy surgery) (3), electrical stimulation of the cerebellum (4) or thalamus (5), and a high-fat, lowcarbohydrate diet (the ketogenic diet). However, some patients refuse intracranial surgery and others are not good candidates based on test results, the efficacy, and safety of deep brain stimulation is not proven, and adults do not generally respond to the ketogenic diet.
