Brain surgery for epilepsy means patients still free of fits 30 years later

A study has shown that thirty years after undergoing temporal lobectomy for epilepsy, half of patients are still free from seizures.

Temporal lobectomy involves surgical removal of the temporal lobe of a cerebral hemisphere to eliminate the focus of electrical activity that triggers epileptic seizures.

The study from the National Institute of Neurological Disorders and Stroke (NINDS) looked at 48 patients who underwent temporal lobectomy between 1965 and 1974.

Dr. William H. Theodore and Kathy Kelley, reported that from the original group, 27 patients were seizure free or experienced only non-disabling auras one year after surgery, and thirty-two had at least one postoperative seizure at some point.

The researchers found that some patients had a fluctuating course, with 15 percent experiencing a change in seizure control over periods of as long as a decade.

But after an average follow-up of 29.9 years, 50 percent were seizure free.

Of the group ten had died, but only three of those deaths were a direct result of epilepsy.

Dr. Theodore says current surgical treatment of epilepsy is likely to result in even better outcomes, as improved technology such as neuroimaging with MRI and PET scans, means surgeons can remove the minimum amount of brain tissue in order get a good result.

He maintains that many patients wait far to long, sometimes decades, before deciding to have surgery.

He recommends that surgery be considered for patients who have focal epilepsy, if they have not responded to at least two antiepilepsy drugs given in good doses for several months, and says if the seizures can be stopped during adolescence it is a tremendous advantage.

The study is published in the current edition of Neurology, June 14, 2005.