Emerging technologies and strategies in epilepsy surgery: toward personalised medicine

Abstract

Epilepsy surgery, the treatment of choice for drug-resistant focal epilepsy, is evolving rapidly. This progress is driven by a growing interest in the network theory of epilepsy, advances in data-driven models, and a focus on personalised treatment approaches. As a result, treatment options have expanded to include minimally invasive procedures, neurostimulation devices, and network-based interventions. Predicting surgical outcomes-such as seizure freedom and neuropsychological effects-remains challenging but is improving through advances in computational technology and molecular research, paving the way for more precise surgery. Despite these advancements, disparities in access to treatments persist, particularly in resource-scarce settings, highlighting the need for systemic solutions to improve access. Emerging research into genetic and multi-omic markers might assist in tailoring treatments and improving the prediction of outcomes. Future directions include integrating minimally invasive techniques, refining neuromodulation strategies, and leveraging molecular and computational tools to optimise patient care. Multidisciplinary collaboration will be essential to overcome challenges, reduce disparities, and advance surgical outcomes for patients with drug-resistant epilepsy worldwide.