Epilepsy surgery stands test of time

Examinations of people who 30 years earlier had elected to have brain surgery for epilepsy show that half of them have been free of seizures nearly all of that time.

William H. Theodore and Kathy Kelley of the National Institute of Neurological Disorders and Stroke (NINDS) in Bethesda, Md., contacted 48 epilepsy patients who had had the operation between 1965 and 1974. In each of these patients, doctors had removed a portion of either the right or left temporal lobe, depending on where the individual’s seizures occurred. The corresponding brain portion in the other, intact temporal lobe was able to compensate for the cognitive functions formerly orchestrated by lost tissue.

Since their surgery, 21 of the study participants have had no seizure that caused loss of consciousness. Three others have been free of such seizures for at least 19 years. The rest were never completely free of seizures or had died since the surgery, the researchers report in the June 14 Neurology.

Although the temporal lobe surgery is a standard option for people in whom epilepsy seizures aren’t prevented by drugs, many people shy away from it.

“We think [the surgery] is underutilized,” Theodore says. “People see it as an irrevocable step and don’t want their brain operated on,” even though the risk of side effects from the operation is very low (SN: 8/4/01, p. 69: Surgery for epilepsy outshines medication). He estimates that only a few hundred such surgeries are done in the United States each year.