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Page: << Prev | 1 | 2 The findings were published in the Dec. 3 issue of the Journal of the American Medical Association.
An estimated 20 percent to 40 percent of people with epilepsy do not respond to drugs, and are more likely to die early than people who do benefit from medication.
Yet despite scientific evidence and a statement from the American Academy of Neurology that temporal lobe surgery reduces seizures (two-thirds of patients become seizure-free) and improves quality of life, such surgery appears to be greatly underused.
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According to an editorial in the same issue of the journal, an estimated 100,000 patients in the United States alone could be candidates for surgical treatment, but less than 2,000 actually had such a procedure in 1990.
What's more, those who do have surgery are often referred late, after an average of 20 years of illness. This delay may result from difficulty in diagnosing tough cases early enough. And new drug treatments may actually have lengthened the time to surgery, the editorial stated.
Temporal lobe epilepsy (when seizures come from the temporal lobe region of the brain) is the most common form of epilepsy, and the most amenable to surgery.
For the new study, the researchers used the "Monte Carlo" computer simulation model, which evaluated information on possible surgical complications, quality-of-life information, and patients' seizure status.
Surgery was the preferred treatment in almost 100 percent of the simulations, increasing survival by five years. When considering quality-adjusted life years (QALYs), surgery was preferred 96.5 percent of the time and increased QALYs by 7.5 years. Patients, who were an average of 35 years old, would gain 15 more years without seizures, the study found.
The benefits are likely understated, according to the editorial, by Dr. Jerome Engel Jr., a neurologist at the David Geffen School of Medicine at the University of California, Los Angeles. The reason: The model patient used in this study was 35 years old, and many people could benefit from surgery much earlier.
More information
Learn more about temporal lobe epilepsy at the New York University Comprehensive Epilepsy Center.
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