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For Many, Epilepsy Surgery Effective Long-Term
Date:10/14/2011

away a small part of the brain where seizures start. Most often this is an area of the temporal lobe, and this procedure is known as an anterior temporal resection. But depending on the location of the "seizure focus," which doctors determine with MRI and other tests, epilepsy surgery may be performed on other areas of the brain.

Temporal lobe surgery usually doesn't impair the patient's mental abilities or memory, the researchers said.

Surgery outside the temporal lobe is called extratemporal cortical resection. The researchers found that patients who underwent extratemporal resections were twice as likely to have seizures return as those who had a temporal resection.

In addition, patients who had simple partial seizures in the two years after surgery were 2.5 times more likely than others to have seizures that did affect consciousness.

Also, the longer patients remained free of seizures, the less likely they were to relapse. But remission was less likely the longer seizures persisted, the authors noted.

In some patients, use of a previously untried antiepileptic drug was linked to fewer seizures after surgery, but the study wasn't designed to evaluate medications.

Most patients chose to continue taking epilepsy drugs after surgery, but at the end of the follow-up period, 28 percent of those who were seizure-free stopped taking them altogether.

No patients saw a significant worsening of their epilepsy after surgery, the researchers noted.

In the first year post-surgery, 82 percent were seizure-free or only had simple partial seizures, but that didn't indicate a cure.

Dr. Joseph I. Sirven, professor and chairman of the department of neurology at the Mayo Clinic in Arizona and chair-elect of the Professional Advisory Board at the Epilepsy Foundation, explained the significance of the research, saying "this is one of the largest series of epilepsy surgery patients which included both temporal and extratem
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