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Epilepsy Surgery Works For Many

Most Patients Seizure-Free Up to 8 Years after Epilepsy Surgery
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WebMD Health News

Aug. 25, 2003 -- Most epilepsy patients who are seizure-free one year after treatment with epilepsy surgery are likely to be free from seizures for up to eight years or more, a new study shows.

Researchers found 68% of patients with the type of epilepsy that is not relieved by medication (known as intractable epilepsy) who were seizure-free for a year after epilepsy surgery were also free of seizures for an average of more than eight years after the treatment.

Epilepsy surgery involves removing a small portion of the brain that is associated with generating seizures and is generally considered the last treatment option for people with the most serious forms of epilepsy.

Epilepsy is defined as a condition caused by abnormal brain activity that leads to repeated seizures, which may range in severity from mild muscle spasms to loss of consciousness, and affects more than 2 million Americans.

Long-Term Outlook Good

The study, published in the journal Neurology, included 175 patients who had epilepsy surgery between 1972 and 1992 and provides one of the first long-term looks at the success of the procedure.

Of the 175 patients followed for an average of more than eight years, 65 experienced a relapse of their epilepsy. Among those, 51% had one or fewer seizures per year, which suggests that their disease relapse was also less severe than the original disease.

"Little is known about seizure recurrence in patients five, 10, or 20 years after surgery, and one year isn't enough to follow up a patient who had surgery," says researcher Susan S. Spencer, MD, of Yale University Medical School, in a news release. "The number of patients who didn't relapse in this study was larger than we thought it would be."

Researchers found that how long a person suffered from epilepsy before treatment with epilepsy surgery was a significant predictor of the long-term success of the treatment. Those who had epilepsy surgery within the first 10 years of having epilepsy were much more likely to be seizure- free over the long run compared with those who had epilepsy for more than 20 years prior to surgery.

People who had epilepsy for more than 20 years before epilepsy surgery were also more likely to experience auras or warning signals of an impending seizure at some point after surgery.

Earlier Consideration May Be Needed

In an editorial that accompanies the study, Edwin Trevathan, MD, MPH, director of the pediatric epilepsy center at Washington University in St. Louis and colleagues, say the study raises the question of whether surgery should be considered earlier for people with epilepsy.

"Unfortunately, so few patients had surgery within the first 10 years of their epilepsy that we do not know if earlier intervention would have offered these patients improved odds for seizure freedom," they write.

"Surgery has been considered as the last treatment option for patients with intractable epilepsy, but it is clear that surgery should be considered sooner, especially among patients who have failed to achieve seizure freedom without side effects after treatment with a second anti-epileptic drug," says Trevathan, in a news release.

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