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Patients appear well adapted post-surgery, with a reduced long-term impact of epilepsy and surgery, while factors linked to cognitive compensation and reduced stress appear increasingly relevant.
Over four decades, the referred population changed markedly: fewer surgical referrals, older patients, more new- and late-onset epilepsies, and more focused, less severe impairment.
Whereas AMD was generally manageable and successfully integrat-ed into everyday life, SMD disrupted identity, autonomy, and expected life trajecto-ries, and current surgical pathways appear to address these cognitive sequelae insufficiently.
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