The national temporal lobectomy survey

OBJECTIVE To assess selection criteria for temporal lobectomy and to evaluate the process for pre-surgical evaluation, informed consent, and the definition of success. METHODS We constructed an electronic survey instrument composed of 26 questions and sent it to epileptologists and neurosurgeons at 105 US epilepsy centers. RESULTS While variation with the number of drug failures that signify pharmacoresistance and surgical candidacy exists, there does appear to be a consensus. The definition of a successful surgery also varies. Furthermore, physicians differ with regard to appropriate preoperative tests that determine surgical candidacy and may predict surgical outcome. The informed consent process provided is thorough for some aspects of surgery and incomplete for other significant aspects. CONCLUSION The data show that the neurological community currently does not have consistent definitions and practices in the management of pharmacoresistant epilepsy. Therefore, there appears to be need for developing a unified approach.