Decision-making in Surgical Epilepsy with Dr. Kai Miller Artwork

ASSFN Podcast

Join us as we discuss exciting topics and updates in the field of Functional Neurosurgery, encompassing surgical treatment of movement disorders, epilepsy, pain and psychiatric disorders. We will have monthly episodes of 15-20 minutes accessible to listeners of all levels from medical students, residents, fellows, attendings or anyone who wants to learn more about Functional Neurosurgery. Our formats are varied and include guest speakers, case discussions, journal articles, practice building tips, Q&A sessions. We welcome suggestions for topics and want to focus on what you would like to hear, so please reach out to us and follow us at @ASSFNeurosurg, @danikapaulomd, @robertzmd, @TessaHarland, or @rushnaali6 with topic suggestions, questions and announcements for upcoming sessions!

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ASSFN Podcast

Decision-making in Surgical Epilepsy with Dr. Kai Miller

February 12, 2026 • ASSFN

0:00 | 33:50

In this episode of the ASSFN Podcast, Dr. Kai Miller (Functional Neurosurgeon at Mayo Clinic in Rochester, MN) talks with cohosts Dr. Robert Ziechmann (Jefferson S&F Neurosurgery Fellow) and Andreas Seas (Duke Medical Student) about surgical decision-making in epilepsy, centered on the principle of concordance—aligning seizure semiology, imaging, and electrophysiology to guide treatment. He reviews how multidisciplinary evaluation, stereo-EEG, and functional mapping shape decisions between resection, laser ablation, disconnection, and neuromodulation.

The conversation highlights challenges in dominant temporal lobe epilepsy, balancing seizure freedom with language and memory preservation, and contrasts approaches in pediatric versus adult patients. Dr. Miller also reflects on advances in imaging, evolving thalamic stimulation targets, and the importance of humility, transparency, and patient-centered counseling in epilepsy surgery. Take a listen to his valuable insights!