ABSTRACT
Selection of patients based on a history suggesting focal onset of seizures or those with clearly defined epileptiform abnormalities is too restrictive and excludes some patients who do not meet these rigid criteria on initial evaluation. Thus, some patients likely to benefit from surgery might be denied this opportunity if the readers were to select only those patients who on initial evaluation present with clearly defined partial epilepsy. Even if some patients are found not to be suitable surgical candidates, prolonged monitoring at an epilepsy center can establish the seizure type and epileptic syndrome with greater precision. An assessment is made of what support systems are available to the patient both during evaluation and after surgery. Patients found to be suitable candidates for further evaluation then undergo a Wada test (intracarotid amytal) for speech and memory lateralization, visual fields, neuropsychological testing, and speech and psychiatric evaluation.
