The effectiveness of surgery in the management of epilepsy

CRD COMMENTARY: The literature search is good but the authors have not stated inclusion and exclusion criteria. It is possible that publication bias exists, and that additional relevant studies may have been missed, by excluding non-English publications. Extracted data is reported in several tables and discussed in a narrative review which was appropriate because of the lack of trial data. The authors have not reported on how the articles were selected and they do not report who performed the data extraction. The quality of the included studies was not assessed. The authors did not test for homogeneity but the differences between studies and their drawbacks are acknowledged in the discussion. The authors acknowledge that there was a lack of trial data, a likely referral bias in case series from the major centres, differences in practice between trial centres, and the process of evaluation of patients for surgery for epilepsy is evolving rapidly. The authors believe that these critiques probably influence the conclusions and guidelines drawn from the review. The review should be viewed with caution because of the methodological omissions in the process and the criticisms of the data raised by the authors.