After failure of two anti-seizure medications, it’s time to start the conversation about epilepsy surgery

Timely referral to an epilepsy surgery evaluation allows parents to exercise their right to make an informed treatment decision for the child.

Help us stop the delay


of neurologists did not know the definition of drug-resistant epilepsy


of neurologists believe a patient must fail all approved anti-seizure medications before drug-resistance is established


of neurologists considered epilepsy surgery a treatment of last resort

“There is a widespread lack of physician awareness regarding the current criteria for AED resistance, resulting in failure to recognize the need for presurgical evaluation and referral.”

Elena Solli,Nicole A. Colwell, Irene Say, Rebecca Houston, Anmol S. Johal, Jayoung Pak,Luke Tomycz

The interval from seizure onset to epilepsy surgery in children is approximately five years. Surgical outcomes depend on several factors, including duration of epilepsy. “The ‘time is brain’ axiom, often used in the stroke community, also holds true for children with epilepsy.”

Kees P. J. Braun and J. Helen Cross

“Drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom.”

Patrick KwanAlexis ArzimanoglouAnne T BergMartin J BrodieW Allen HauserGary MathernSolomon L MoshéEmilio PeruccaSamuel WiebeJacqueline French

“Children with seizures that are uncontrolled by medical treatment (i.e., failure of two or three appropriate drugs) or are disabling (including medication
side effects) are possible surgical candidates.”

J. Helen Cross, Prasanna Jayakar, Doug Nordli, Olivier Delalande, Michael Duchowny, Heinz G. Wieser, Renzo Guerrini, Gary W. Mathern, International League Against Epilepsy, Subcommission for Paediatric Epilepsy Surgery; Commissions of Neurosurgery and Paediatrics

“The presurgical referral process is perceived by caregivers as slow and arduous.” Some parents have to contact tertiary epilepsy centers themselves and struggle with finding the right treatment teams. Because epilepsy surgery is not discussed as an option, parents are unable to participate in informed treatment discussions for their children.

Time is brain

Referring a child for an epilepsy surgery evaluation doesn’t mean anyone has decided a child will have epilepsy surgery. It means all treatment options will be determined so that parents can make informed healthcare decisions for the child.

Help us stop the delay to surgical evaluation.