Forty-three patients who had the choice between anterior temporal lobectomy (ATL) and LITT were included. All but one patient reported having adequate information to make an informed surgical decision.  Over half of patients felt having multiple surgical options made them more likely to consider epilepsy surgery.  Among the patients who chose ATL, the interaction of seizure freedom with surgery invasiveness was statistically significant (p<0.001) with seizure freedom more important than surgery invasiveness. Both groups felt surgical risk was relatively low with LITT patients having numerically higher average risk perception compared to ATL. Patients perceived both physician and family/friend preference for which surgery they should have, but only a minority of patients noted family/friend pressure as to which surgery they should have.  Seizure freedom was the most common factor cited in deciding what surgery should be performed, although the responses in the LITT group were more varied. 

For subjects choosing ATL, seizure freedom is statistically more important than the invasiveness of the surgery. Having multiple surgical options may make some patients more likely to consider epilepsy surgery.  Physicians provide adequate counseling to enable patients to make mutually agreed upon therapeutic surgical decisions.