{
  "abstract": "This practice guideline from the American Epilepsy Society (AES) and the Congress of Neurological Surgeons (CNS) provides evidence-based recommendations for surgical treatment of epilepsy for adults and children. It is an update to previous practice parameters published by the Academy of Neurology in 2003. The multidisciplinary panel addressed resective procedures for mesial temporal epilepsy (MTLE), neocortical epilepsy, and resection/disconnection of hypothalamic hamartoma. It also examined evidence for callosotomy in developmental and epileptic encephalopathies. It did not intentionally address neurostimulation treatment. A comprehensive literature review was conducted using the Grading of Recommendations Assessment, Development and Education (GRADE) methodology, and GRADE was also used for decision-making. This guideline considers not only seizure outcomes but also other critical and important outcomes. Seizures, quality of life, mortality, adverse events, and verbal memory loss were considered critical outcomes, while other neuropsychological deficits besides verbal memory loss (ie, naming, fluency), neuropsychiatric, and social outcomes were considered important outcomes. Following the GRADE process, the following strong recommendation was made based on a moderate level of evidence: (1) anterior temporal lobectomy (ATL) is recommended for people with MTLE at low risk for cognitive decline. Due to very low to low certainty of evidence the panel suggested the following conditional recommendations: (1) ATL for people with MTLE at high risk for cognitive decline, (2) selective amygdalo-hippocampectomy (SAH) in MTLE, (3) laser interstitial thermal therapy (LITT) in MTLE, (4) neocortical resection in neocortical epilepsy, and (5) callosotomy in people with drop attacks, Lennox-Gastaut Syndrome (LGS) or developmental and epileptic encephalopathies. The panel recognized that conditional recommendations need to account for individual patient circumstances and mandate shared decision-making to ensure that decisions align with each person's values and preferences. For hypothalamic hamartoma, the panel strongly recommended LITT despite low levels of evidence due to a paradigmatic situation where open surgery has significant risks that outweigh the benefits. If LITT is not available, the panel suggested radiosurgery for hypothalamic hamartoma (conditional recommendation). The panel highlighted that every person with drug-resistant epilepsy should have access to a tertiary epilepsy care center that performs surgical procedures and advanced epilepsy diagnostics (good practice statement).",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology, Dartmouth Health and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.",
    "Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.",
    "Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.",
    "Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.",
    "Department of Neurosurgery, Department of Pediatric Neurosurgery, Baylor College of Medicine, Houston, TX, USA.",
    "Department of Neurological Surgery, UT Southwestern Medical Center, Dallas, TX, USA.",
    "American Epilepsy Society and Department of Health Sciences, Rush University, Chicago, IL, USA.",
    "Department of Neurology, Dartmouth Health and Geisel School of Medicine at Dartmouth, Hanover, NH, USA.",
    "Epilepsy Center and Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.",
    "Department of Neurology, UCLA Medical Center, David Geffen School of Medicine, Los Angeles, CA, USA.",
    "Department of Neurology, Neuromedical Center, Baton Rouge, LA, USA.",
    "Department of Neurology, Duke University Medical Center, Durham, NC, USA.",
    "Neurosurgery Department, University of Minnesota, Minneapolis, MN, USA.",
    "Department of Neurosurgery, Columbia University Irving Medical Center, New York, NY, USA.",
    "Department of Pediatric Neurology, University of Chicago, Chicago, IL, USA.",
    "Department of Neurosurgery, Mass General Brigham, Harvard Medical School, Boston, MA, USA.",
    "Patient representative, New York, NY, USA.",
    "Department of Neurosurgery, Yale School of Medicine, Yale University, New Haven, CT, USA.",
    "Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA.",
    "Neurology - Epilepsy, The George Washington University, Washington, DC, USA.",
    "Neurosurgery, Yale University, New Haven, CT, USA.",
    "Department of Neurology, The George Washington University, Washington, DC, USA.",
    "Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.",
    "Department of Neurosurgery, McMaster University, Hamilton, ON, Canada.",
    "Department of Surgery, McMaster University, Hamilton, ON, Canada.",
    "Division of Neurosurgery, McMaster University, Hamilton, ON, Canada.",
    "Department of Neurology, University of Chicago, Chicago, IL, USA.",
    "Department of Health Research Methods, Evidence, and Impact, Department of Anesthesia, McMaster University, Hamilton, ON, Canada.",
    "Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 33,
  "authors": [
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      ],
      "name": "Barbara C Jobst",
      "orcid": "0000-0001-9243-2238"
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      "name": "Gregory Bergey",
      "orcid": "0000-0001-7895-7564"
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      "name": "Yetiani M Roldán-Benítez",
      "orcid": "0009-0009-4564-5973"
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      "name": "Jennifer L Hopp",
      "orcid": "0000-0002-2326-0740"
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      "name": "David F Bauer",
      "orcid": "0000-0003-3548-0887"
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      "name": "Angela Price",
      "orcid": "0000-0001-8120-1055"
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      "name": "Shawna L Strickland",
      "orcid": "0000-0003-2113-0835"
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      "name": "James L Bernat",
      "orcid": "0000-0003-1128-0442"
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      "name": "Robyn M Busch"
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      "name": "Jerome Engel",
      "orcid": "0000-0001-6324-5716"
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      "name": "David Gloss"
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      "name": "Aatif M Husain",
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      "name": "Robert A McGovern",
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      "name": "Guy M McKhann",
      "orcid": "0000-0002-9695-3564"
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      ],
      "name": "Douglas R Nordli",
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      "name": "John D Rolston",
      "orcid": "0000-0002-8843-5468"
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      "name": "Richard Shane"
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      "name": "Dennis Spencer"
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    {
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      "name": "Howard L Weiner"
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      ],
      "name": "Mei Bou Nasif",
      "orcid": "0000-0003-2713-7894"
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    {
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      "name": "Taylor Duda"
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      "name": "Alexandra Eid",
      "orcid": "0000-0001-9983-5793"
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    {
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        22
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      "name": "Dina Ghandour"
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      "name": "Shannon Hart"
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      "name": "Mohamad Kesserwan",
      "orcid": "0000-0002-1593-0740"
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      "name": "Amanda Martyniuk"
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    {
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      "name": "Melissa Lannon"
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      "name": "Golbarg T Saber",
      "orcid": "0000-0001-7310-583X"
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    {
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      "name": "Christopher Saouda"
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      "name": "Sunjay Sharma"
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      "name": "Victoria Vinarsky"
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      "name": "Andrea J Darzi",
      "orcid": "0000-0002-2498-1697"
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    {
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      "name": "Jorge Gonzalez-Martinez",
      "orcid": "0000-0002-9936-7034"
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  "bibtex": "https://research.draconitic.com/paper/b0jrhdz8bzqr6.bib",
  "cited_by": 0,
  "doi": "10.1177/15357597261465347",
  "fulltext_url": "https://europepmc.org/articles/PMC13710471",
  "id": "b0jrhdz8bzqr6",
  "issns": [
    "1535-7597",
    "1535-7511"
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  "landing_url": "https://europepmc.org/article/MED/42948139",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Practice Guideline"
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      "2738|Epilepsy research and treatment"
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  "pdf_url": "https://europepmc.org/articles/PMC13710471?pdf=render",
  "pmcid": "PMC13710471",
  "pmid": "42948139",
  "published": "2026-10-26",
  "publisher": "American Epilepsy Society",
  "ris": "https://research.draconitic.com/paper/b0jrhdz8bzqr6.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:33Z",
      "native_id": "MED:42948139",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948139"
    },
    {
      "first_seen": "2026-10-31T12:21:26Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Epilepsy research and treatment",
      "subfield": "psychiatry"
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  ],
  "title": "American Epilepsy Society/Congress of Neurological Surgeons Epilepsy Surgery Clinical Practice Guideline.",
  "title_text": "American Epilepsy Society/Congress of Neurological Surgeons Epilepsy Surgery Clinical Practice Guideline.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:26Z",
  "url": "https://research.draconitic.com/paper/b0jrhdz8bzqr6",
  "venue": "Epilepsy currents",
  "versions": []
}