A new study of epilepsy patients who had surgery to treat their illness decades ago indicates that seizures can be controlled safely and effectively with surgery.
The story begins about 10 years ago, when neurosurgeon Matthew Smyth came to the Washington University School of Medicine in Saint Louis, Missouri, to focus on epilepsy surgery.
"And one of my predecessors, Dr. Sidney Goldring, used to perform these surgeries. And I inherited a large stack of three loose-leaf binders filled with about 350 records from his epilepsy surgery patients and realized that many of those patients could still be identified and located and interviewed."
Smyth and his colleagues tracked down about one-third of those patients who had epilepsy surgery between 1967 and 1990. After all those decades, about half the patients were still completely free of seizures.
Previous studies had similar results, but they followed patients for only for about five or ten years after surgery. "So the fact that it was durable and prolonged for 20, 30, even 40 years in some cases, was meaningful new information for us," Smyth said.
The patients were also asked to complete a 31-point quality of life questionnaire, and "about 80 percent of the patients had improved quality of life by this measurement tool that we used," he added.
Still, surgery - especially brain surgery - is a scary prospect.
"As you can imagine, many families and patients are frightened by the idea of epilepsy surgery, or any kind of surgery. But again, with modern techniques, it's a very safe approach to these patients."
There are alternatives to surgery in a variety of anti-seizure drugs. But these drugs can have significant side effects, they're very expensive, and Smith says that in about one-third of patients, they just don't work.
