▁range ▁of ▁se iz ure - free ▁out comes ▁for ▁these ▁patients ▁is ▁reported ▁to ▁be ▁between ▁ 8 0 ▁and ▁ 9 0 %, ▁which ▁is ▁typically ▁reported ▁as ▁a ▁sub - set ▁of ▁data ▁within ▁a ▁larger ▁surg ical ▁series . ▁ ▁Open ▁surg ical ▁procedures ▁such ▁as ▁A TL ▁have ▁inher ent ▁ris ks ▁including ▁damage ▁to ▁the ▁brain ▁( e ither ▁directly ▁or ▁indirect ly ▁by ▁injury ▁to ▁important ▁blood ▁vessels ), ▁ble eding ▁( which ▁can ▁require ▁re - operation ), ▁blood ▁loss ▁( which ▁can ▁require ▁trans f usion ), ▁and ▁in fection . ▁Furthermore , ▁open ▁procedures ▁require ▁several ▁days ▁of ▁care ▁in ▁the ▁hospital ▁including ▁at ▁least ▁one ▁night ▁in ▁an ▁int ensive ▁care ▁unit . ▁Although ▁such ▁treatment ▁can ▁be ▁cost ly , ▁multiple ▁studies ▁have ▁demonstrated ▁that ▁A TL ▁in ▁patients ▁who ▁have ▁failed ▁at ▁least ▁two ▁ant icon v uls ant ▁drug ▁tri als ▁( there by ▁meeting ▁the ▁criteria ▁for ▁med ically ▁int ract able ▁temporal ▁lo be ▁ep ile ps y ) ▁has ▁lower ▁mort ality , ▁lower ▁mor bid ity ▁and ▁lower ▁long - term ▁cost ▁in ▁comparison ▁with ▁continued ▁medical ▁ther apy ▁without ▁surg ical ▁inter vention . ▁ ▁The ▁strong est ▁evidence ▁supporting ▁A TL ▁over ▁continued ▁medical ▁ther apy ▁for ▁med ically ▁ref ract ory ▁temporal ▁lo be ▁ep ile ps y ▁is ▁a ▁pros pective , ▁random ized ▁trial ▁of ▁A TL ▁compared ▁to ▁best ▁medical ▁ther apy ▁( ant icon v uls ants ),