Resective Epilepsy Surgery Shows Excellent Long-Term Results

Resective epilepsy surgery allows long-term, seizure-free or near-seizure-free living for about 75% of patients, according to a recent report in the medical journal Epilepsy and Behavior. Resective epilepsy surgery removes the area of the brain that causes repeatedseizures.

Researchers followed epilepsy patients who underwent resective surgery between 1993 and 2011, following up every five years. About a quarter of the participants (68 out of 253) were surveyed 15 years after their surgery. This is one of the longest follow-up periods reported for resective epilepsy surgery patients.

The great majority of the patients underwent temporal lobe resection (for the part of the brain on either side, just above the ear). This is an important factor in the overall favorable results, since temporal lobe epilepsy is the most responsive to surgical cure. Nevertheless, it is significant that 58% of patients who underwent extra-temporal resection were also seizure-free or near-seizure-free in the long term.

The study showed that patients’ ability to drive a car increased after epilepsy surgery. Researchers also found an increase in use of antidepressants after resective epilepsy surgery. An overly simplified conclusion may be that patients are more depressed after the procedure. However, a more fitting interpretation would be that these patients are more empowered to manage their depression when their seizures are in remission.

The new study confirms a 1997 Epilepsia finding that resective epilepsy surgery doesn’t improve overall employment status. This likely highlights the need for physicians to initiate this intervention sooner rather than later with appropriate patients, before recurrent seizures can disrupt educational and vocational opportunities.

Why Epilepsy Surgery?

When anticonvulsant medications cause side effects or don’t adequately control seizures, epilepsy surgery can help improve seizure control and even make seizure-freedom possible.

The main reason to consider epilepsy surgery is to reduce harmful effects from seizures. These can include serious injuries from falling, brain damage from prolonged seizures or the risk of sudden death for patients with uncontrolled seizures.

Diagnostic tests show whether surgery is appropriate and if so, which type is best. For an expert consultation with the Cushing Neuroscience Institute’s Comprehensive Epilepsy Care Center, email us or request an appointment online.

This post was written by Cynthia Louise Harden, MD, chief of neurology -- epilepsy and EEG at LIJ Medical Center.

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