Why Referral Timing Matters in Drug-Resistant Epilepsy

Did you know that the average time between seizure onset and epilepsy surgery has been reported to be around 20 years in adults? For patients with drug-resistant epilepsy, that delay matters.

What drug-resistant epilepsy means

Drug-resistant epilepsy is generally defined as continued seizures after two appropriate anti-seizure medication trials. Once drug resistance is established, expert consensus recommends referral for surgical evaluation.

But referral is still often delayed — in part because epilepsy surgery is sometimes viewed as a last resort rather than a timely option.

Why early referral is crucial

Early referral to a specialized epilepsy team can help:

• Confirm the diagnosis and define the epilepsy type, cause, and seizure localization.
• Identify whether a lesion or subtle abnormality is visible on MRI.
• Clarify whether surgery, ablation, neuromodulation, continued medical management, or further testing may be appropriate.
• Address cognitive, behavioral, psychiatric, and other comorbidities earlier.
• Reduce years of uncertainty for patients and families.

Where BrainScores fits

A recurring bottleneck in this pathway is imaging: many patients are labeled "MRI-negative" when subtle structural abnormalities are simply hard to see. BrainScores is built to make that subtle signal more visible — turning routine MRI into quantitative, interpretable maps that support earlier, better-informed decisions on the road to surgical evaluation.