Bibliographic record
Abstract
PURPOSE OF REVIEW: To review recent evidence that can assist clinicians facing the challenging question of when to offer brain surgery for epilepsy. RECENT FINDINGS: The most robust recent evidence pertains to temporal lobe epilepsy. We focus on this syndrome to assess the main issues pertaining to early surgery, which include natural history and effectiveness of medication, risks associated with continued seizures, effectiveness and risks of surgery, and cognitive outcomes in relation to timing of surgery. SUMMARY: The evidence for performing surgery earlier is persuasive but incomplete. Recent evidence indicates that intractability, and therefore consideration for surgery, does not develop at a uniform time in surgical candidates, and that late remissions with medical treatment are not rare. Factors that may suggest sustained intractability include a larger number of medications tried, longer duration of seizures, history of status epilepticus, mental retardation, and nonidiopathic epilepsy. Adequate prospective studies, however, need to address this important question systematically. The evidence regarding morbidity, quality of life, mortality, social and cognitive function suggests that earlier surgery may be beneficial, but prospective controlled studies with standardized interventions and outcomes will be required to derive firm conclusions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".