What factors would prompt you to refer a patient for a surgical epilepsy evaluation who has not yet failed two anti-seizure medications?  

This is a good question, and of course, the discussion with the patient regarding their diagnosis and treatment plan is important. There are also expert consensus guidelines that help to clarify this (Jehi et al., PMID 35842919) and that most of us would ascribe to in these cases. Specifically, when...