The vast majority of epilepsy patients who have brain surgery to treat the
seizure disorder find it improves their mood and their ability to work and
drive, a new study reveals.
A second study also indicates the procedure is safe and effective
for patients over 60.
"They're both reassuring findings," said Bruce Hermann, director
of the Charles Matthews Neuropsychology Lab at the University of Wisconsin
School of Medicine and Public Health.
"Epilepsy is a difficult
disorder to have and live with, coming with a high rate of depression and
affecting the ability to drive and work.
"We always hoped surgery would have positive effects on patients' life
situations, and this research does show that, and shows that the outcomes
persist," added Hermann, who was not involved with the research.
Affecting about 2.2 million Americans and 65 million people globally,
epilepsy is a seizure disorder triggered by abnormal nerve cell signalling in
the brain, according to the Epilepsy Foundation.
More than 1 million Americans with epilepsy suffer from treatment-resistant
seizures that can hamper their ability to drive, work and learn. Epilepsy is
the third most common neurological disorder, after Alzheimer's disease and
Researchers from Henry Ford Hospital in Detroit, conducting phone interviews
with more than 250 epilepsy patients who had brain surgery there between 1993
and 2011, found that 92% considered the surgical treatment worthwhile. More
than three-quarters of those undergoing surgery on their brain's temporal lobe
the most common site to remove brain tissue triggering seizures were later
seizure-free or experienced only rare disabling seizures.
About half of the patients reported being able to drive at the time they
were interviewed, compared to 35% who were able to do so before surgery. Those
with favourable surgical outcomes also were more likely to be working and less
likely to be taking antidepressants, the investigators found.
"It was very encouraging to document the patients' perspective about
the value of surgery," said study co-author Dr Marianna Spanaki, director
of the epilepsy monitoring unit at Henry Ford Hospital. "If presurgical
evaluation is delayed, people with epilepsy suffer from ongoing medication and
seizure side effects that compromise their quality of life."
The second study, by researchers at University of California, Los Angeles,
found that 90% of epilepsy patients aged 60 and older undergoing brain surgery
experienced good outcomes, with 70% of them becoming seizure-free. The study
authors said the data demonstrates that older age alone shouldn't necessarily
block consideration of epilepsy surgery.
Between 100 000 and 200 000 epilepsy patients in the United States are
candidates for epilepsy surgery, which is typically, considered when seizures
continue despite the use of several types of anti-seizure drugs, Spanaki
Patients undergo a pre-surgical workup that provokes seizures under close
observation and determines which part of the brain generates seizures and can
be safely removed.
While vision problems occur in a small number of epilepsy surgical patients,
she said, major complications are rare. Private insurance plans and Medicare
typically cover all expenses associated with the procedure, Spanaki said.
"There's a misconception that the more anti-seizure drugs people with
epilepsy try, the better chances they have to achieve seizure freedom or
reduction," she said. "This notion delays referrals for pre-surgical
Hermann added: "In general, it's better to consider epilepsy surgery
sooner rather than later."
The Epilepsy Foundation offers more information about epilepsy.