Surgery crucial for people with drug-resistant epilepsy

By Angela Betsaida B. Laguipo, BSNSep 12 2019

Epilepsy is a chronic, central nervous system or neurological disorder wherein the brain activity becomes impaired, leading to seizures. In some cases, it leads to periods of unusual behavior, loss of awareness, or altered sensations.

Due to the illness being a brain disorder, it can affect various systems in the body, and it stems from changes in the development of the brain, chemicals, or wiring. Epilepsy disrupts normal brain functioning, affects the heart’s rhythm, and breathing problems.

In severe cases of epileptic seizures, a person may need medicines to control the condition. However, there are people who become drug-resistant to these medicines. Now, a new study shows that early surgery for people with drug-resistant epilepsy is crucial, and they have a better chance of becoming seizure-free.

In a new study by researchers at Sahlgrenska Academy and the Swedish Council for Assessment of Health Technology and Social Services (SBU), they found that people with drug-resistant epileptic seizures should promptly be referred for surgical evaluation.

Image Credit: Rainer Fuhrmann / Shutterstock

The earlier, the better

To land to their findings, which was published in the journal Neurology, the researchers analyzed and studied a compilation of previous studies, particularly systematic literature overviews and meta-analysis of studies. They aimed to study the link between early or later surgeries and the chances of becoming seizure-free.

“Drug-resistant epilepsy affects every aspect of life, and no other treatment is as effective as epilepsy surgery. Before the surgical option is chosen, an advanced investigation is needed, to show that the person's attacks come from this limited region in the brain," Kristina Malmgren, senior professor at Sahlgrenska Academy and consultant physician at Sahlgrenska University Hospital, said in a statement.

The study provides support for the basis that drug-resistant epilepsy patients have better chances of being surgery-free, or a reduced frequency of bouts, if they undergo epilepsy surgical treatment, compared to their counterparts who continue taking drug treatment only.

After the analysis of 12 studies that investigated the outcomes of surgery on epilepsy patients, there is a 15 to 21 percent higher chance of being seizure-free, particularly for those who undergo surgery earlier. The researchers, however, said that further research is needed to gather information from more studies. Also, these studies were observational, and to further prove the body of knowledge; it’s important to conduct more comprehensive studies.

Epilepsy by the numbers

Epilepsy affects 50 million people across the globe, the World Health Organization (WHO) reports. Nearly 80 percent of people with epilepsy are living in low-and middle-income countries. Without proper treatment, the risk of premature death in epileptic patients is up to three times higher than for the general population.

In the United States, about 1.2 percent of the total US population have active epilepsy in 2015. That’s roughly 3.4 million people, wherein 3 million are adults, and about 470,000 are children.

What to do during a seizure attack?

Seizures do not usually require medical attention immediately. You can call emergency services if one of the following is present.

• The patient had never had a bout of seizure in the past.
• The seizure lasts more than five minutes.
• The patient has a difficulty of breathing or waking up after the seizure.
• The person had an injury during the attack.
• The patient has another seizure soon after the first one ceased.
• The seizure attack occurred in water
• The patient has an underlying health condition, such as heart disease or diabetes.
• The patient is pregnant.

The first aid for a seizure attack involves making sure the breathing of the patient isn’t blocked. Also, the most important thing to do is to ensure the patient’s safety. Stay with the patient until the seizure ceases, or if he or she is fully awake.

After the seizure attack, assist the patient in a comfortable and safe position. Ask the patient about what happened to make sure they’re alert. Check the patient for any medical bracelet or any vital emergency information. If you think the patient needs further evaluation and medical treatment, assist him or her to the emergency room.

It is important not to hold the person down or try to stop the patient’s movements. Do not move the patient; just remove any hazardous items in the surroundings. Do not put anything in the patient’s mouth that can injure the jaw and teeth. Do not give water or food until the patient is fully awake or conscious.