Despite the success of this trial, "there are still a lot of barriers to overcome" before surgery is more widely used, Kim said. One is lack of access to specialized centers that evaluate epilepsy. "There are only a handful on the West Coast," including UC Irvine and UCLA.
Cost can be a major obstacle to surgery. Many insurance companies will not pay for it because of what Kim terms "the misguided impression that it is cheaper to pay for medicines and emergency room visits than to pay for surgery." Many potential candidates have no insurance at all because their condition prevents them from holding down a job.
For patients whose epilepsy cannot be controlled by drugs and who are not eligible for surgery, another possibility is a new device called a vagus nerve stimulator, which acts like a pacemaker for the brain. The new device has been shown to control seizures in many patients.
"The good news is that we have more options than ever before," Barkley said. "This is a time of great hope for epilepsy patients."