Epilepsy surgery shows promising results, says study

Man holding head in hands Surgical treatment for epilepsy is being used more and more

Related Stories

People who cannot control their epilepsy with medication should be referred sooner for surgery, suggests a study in The Lancet.

The University College London study found that 47% of patients who had surgery were free of seizures after 10 years.

It tracked 615 adults annually over an average of eight years.

But experts say people should be realistic about the risks and benefits of this kind of surgery.

Surgical treatment for epilepsy is being used more and more.

Two-thirds of people with epilepsy have the condition well controlled with medication and experience no side-effects.

The other third, for whom medication does not work, could be eligible for surgery.

The most common type of surgery undertaken on people in the study was temporal lobe surgery, which focuses on the area of the brain behind the forehead between the ear and the eye, where most seizures originate.

Researchers who carried out the study, published in The Lancet, reported that 63% of all patients were free of seizures two years after surgery (excluding simple partial seizures), 52% after five years and 47% after 10 years.

Those with simple partial seizures (SPS) in the first two years after temporal lobe surgery were two-and-a-half times more likely to experience subsequent seizures than those who experienced no SPS.

Start Quote

Clinical practice needs to change with the early referral of appropriate patients”

End Quote Dr Ahmed-Ramadan Sadek and Professor William Peter Gray

This has implications for decisions to stop taking anti-epileptic medication, say the authors.

They found that a relapse was less likely the longer a person was free of seizures after surgery, and more likely the longer seizures continued after surgery.

Realistic about risks

Most patients who were seizure-free after surgery still chose to remain on an anti-epileptic drug of some kind.

John Duncan, medical director at the Epilepsy Society and professor of neurology at University College London's Institute of Neurology, which carried out the study, said the study gave a realistic view of the long-term outcomes of surgery for epilepsy.

"It means people should consider surgery sooner rather than later, while being realistic about the risks too."

The study says that the selection process for surgery and surgical methods need to improve to increase success rates and to more accurately identify those who will not benefit from surgery.

Prof Duncan said the threshold for surgery had come down over the past 20 years.

"Surgery used to be offered to someone having three or four seizures a month. Now it could be offered to someone having one seizure a month, who is in employment but who is experiencing side-effects from the drugs.

"So the stakes are higher. The balance of risk and benefit has changed as surgery is offered to those less severely affected."

Commenting on the findings of the study in The Lancet, Dr Ahmed-Ramadan Sadek and Professor William Peter Gray from the Wessex Neurological Centre at the University of Southampton said the study validated the long-term effectiveness of epilepsy surgery.

But there were still hurdles to be overcome, they said.

"The median duration of epilepsy before surgery in this study was 20 years. In view of the long-term results of surgery shown, clinical practice needs to change with the early referral of appropriate patients."

More on This Story

Related Stories

The BBC is not responsible for the content of external Internet sites

More Health stories


Features & Analysis

  • Cartoon of women chatting on the metroChat wagon

    The interesting things you hear in a women-only carriage

  • Replica of a cargo boxSpecial delivery

    The man who posted himself to the other side of the world

  • Music scoreFinal score Watch

    Goodbye to NYC's last classical sheet music shop

  • Former Secretary of State Hillary Rodham Clinton checks her Blackberry from a desk inside a C-17 military plane upon her departure from Malta, in the Mediterranean Sea, bound for Tripoli, Libya'Emailgate'

    Hillary gets a taste of scrutiny that lies ahead

Elsewhere on the BBC

  • Woman standingMysterious miracle

    It's extremely unusual and shouldn't give false hope, but what makes the body beat cancer on its own?


  • A cyborg cockroachClick Watch

    The cyborg cockroach - why has a computer been attached to this insect’s nervous system?

Try our new site and tell us what you think. Learn more
Take me there

Copyright © 2015 BBC. The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.