When a
brain abnormality can be documented to be the site of origin of intractable
epilepsy, surgical removal of this area is a highly effective treatment. The
procedure can decrease the frequency of seizures, or even stop the seizures entirely. Continuing
anticonvulsant medications after surgery is usual but not necessarily in every
case.
In a recent
study, 15 epilepsy centers in France followed 207 patients over five years.1
The surgical group consisted of 119 patients; 88 were in the medical group
treated only with anticonvulsant medications. Effectiveness was defined as 1
year without a seizure.
Sixty-nine
percent of patients in the surgical group but only 12.3 percent of the
medically treated group were completely seizure-free during the second year of
follow-up. After five years 76.8 percent of the post-surgery group and 21
percent of the medically treated group were seizure-free.
If seizures
are disrupting your life, especially complex partial seizures, I encourage you
to ask your physician if surgical treatment is appropriate. It can possibly be
curative. Surgical treatment should be considered early in the course of your
epilepsy after it is clear that your medications fail to produce satisfactory
control.
- M-C Picot, A Jaussent, D Neveu, et.al. Cost-effectiveness analysis of epilepsy surgery in a controlled cohort of adult patients with intractable partial epilepsy: A 5-year follow-up study. Epilepsia Oct. 2016; 57: 1669-1679.
