Sammanfattning
About one third of patients with epilepsy do not become seizure-free despite medication. For some, resective epilepsy surgery is the treatment of choice. There are three randomized controlled trials, with positive results at a follow-up of 1-2 years: two on temporal lobe resections on adults and young people and one on all types of epilepsy surgery on children. Since 1990 all epilepsy surgery procedures in Sweden are reported to the Swedish Epilepsy Surgery Register, now with data on almost 1500 patients. Two years after surgery about 50% of adults and children are seizure-free, and another 10% have been so during the last year. After 10 seizure-free years 40% of adults and 80% of children have stopped medication. All patients with pharmacoresistant focal epilepsy should be referred to the regional epilepsy team for evaluation and possibly epilepsy surgery. Small children should be referred to the regional pediatric team early, since the epileptic seizures may hamper their development.