Epilepsy surgery is increasingly used to treat intractable childhood-onset epilepsy although it remains an underused treatment option. Advances in technology allowing more accurate identification of the epileptogenic zone along with a better understanding of the benefits of both curative and palliative epilepsy surgery have resulted in an increase of potential candidates. This review covers factors contributing to medical intractability and then details the evaluation of potential surgical candidates. We discuss pre-, peri-, and postoperative variables that lead to curative procedures and highlight the role of palliative epilepsy surgery in cases in which seizure freedom is unlikely.
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