Epilepsy Surgery Works For Many
Most Patients Seizure-Free Up to 8 Years after Epilepsy Surgery
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
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
"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.