For Pre-Surgical Evaluation Pathway for Epilepsy Surgery, watch for Medically refractory: failed ≥2 appropriate, tolerated AEDs, fMRI: non-invasive mapping of motor/language cortex to guide resection, and Depth electrodes: invasive EEG for precise focus localization when non-invasive tests inconclusive when choosing therapy, counseling about risk, planning monitoring, and deciding when closer follow-up or escalation is needed.

Medically refractory: failed ≥2 appropriate, tolerated AEDs; fMRI: non-invasive mapping of motor/language cortex to guide resection; Depth electrodes: invasive EEG for precise focus localization when non-invasive tests inconclusive; 10-20% refractory temporal lobe epilepsy harbors neoplasms; Favorable driving factors: provoked seizures, sleep-only seizures