About 30% of people with epilepsy continue to have seizures despite a growing array of antiseizure drugs. For some of these people, surgical resection of brain tissue is an effective therapeutic option. For others, the likelihood of seizure freedom is low, and has not improved much despite the introduction of several new antiseizure drugs. The vagus nerve stimulator is the only device approved by the Food and Drug Administration (FDA), but it rarely results in freedom from seizures. Recently, 2 approaches to electrical stimulation of the brain have been reported. One device has been approved for use in Canada and in Europe, and it seems likely that one or more such devices will be approved for use in the United States. We examine some of the data from these studies in the context of the current FDA-approved drugs and devices.