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Newer epilepsy surgeries
  1. Michael Samuel1,2,
  2. Richard Selway3
  1. 1General Neurology, Movement Disorders and Deep Brain Stimulation, East Kent Hospitals NHS Trust, UK
  2. 2King's College Hospital, London, UK
  3. 3General Neurosurgery, Epilepsy and Movement Disorders Functional Neurosurgery, King's College Hospital, London, UK
  1. Correspondence to Dr. Michael Samuel, General Neurology, Movement Disorders and Deep Brain Stimulation, King's College Hospital, London, UK; m.samuel{at}nhs.net

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Technology for the generalist. Evidence for the specialist. Individual outcomes for the patient

In their JNNP paper, Gooneratna et al1 review long-term studies of three surgical therapies for pharmacoresistant focal epilepsy: vagal nerve stimulation, which provides the most evidence, anterior thalamic nucleus deep brain stimulation (ANT DBS) and cortical responsive stimulation (CRS). Written for the generalist, the review describes the three technologies in detail. The multiple layers of information gathered inform the generalist of how complex treatment decisions can be. As medical intractability can be predicted early, typically after failure of a second drug or the presence of abnormal imaging, this serves as a reminder that such patients should be considered for early referral to a specialist multidisciplinary …

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