Figure 1 . Control of epilepsy by treatment type in the United States. Patients can be evaluated on an out or in patient basis, with multidisciplinary input. Following evaluation, the patient's case is presented in a conference setting to discuss the best course for treatment. In this issue of NeuroLink, we explore the evaluation and treatment options for the person who is not responding to first line, or routine treatment of their seizure disorder.
Accurate diagnosis is always at the forefront of successful medicine.
A careful history is helpful. Any lesional irritation leading to seizure activity may result in refractory seizure patterns. A physical examination demonstrating focal or asymmetry of neurological function justifies obtaining neuroradiographic information. Therefore, PET can be more sensitive than an MRI, without necessarily being specific. Clearly there is a dichotomy of theory versus practice.