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Vladimir Hachinski, MD, FRCPC, DScMed
London, Ontario

Arch Neurol. 1998;55:234.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

THE MORE desperate the patient and the physician, the more likely patients are to respond to a new treatment. Seasoned epileptologists estimate that about 50% of patients with epilepsy obtain good control with monotherapy, a further 15% with the addition of a second drug, and an additional 5% with polytherapy. That leaves about 30% who need a new treatment. Although both Ben-Menachem and McLachlan assume the effectiveness of resective surgery, this procedure has yet to be proved effective in a rigorous, prospective randomized trial. This keeps the door open for new therapies, such as vagus nerve stimulation (VNS).

Ben-Menachem marshals persuasive experimental, physiological, and clinical trial evidence for the effectiveness of VNS. However, McLachlan points out that being wired and experiencing the surges of stimulation is not the same as taking medication, casting doubt on the blind nature of the trials. Moreover, if more patients . . . [Full Text of this Article]

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