Epilepsy surgery can eliminate seizures for 60 to 85 percent of people with temporal lobe epilepsy who do not respond well to medications. But surgery leads to memory problems in 25 to 40 percent of people. New research helps doctors and patients weigh the risks and benefits of surgery.
The study, published in the June 5, 2007, issue of Neurology®, the scientific journal of the American Academy of Neurology, shows that quality of life improves for people after surgery if their seizures are controlled, even if they develop memory problems.
"This is important information that can help people decide whether or not to undergo surgery," said study author John T. Langfitt, PhD, of the University of Rochester in Rochester, N.Y. "It suggests that the benefits of controlling seizures outweigh the downsides of memory problems. It may be that people can learn to compensate for memory problems more easily and effectively, such as by making lists and using an electronic organizer, than they can compensate for the restrictions that seizures can cause, such as not being able to drive."
Langfitt also noted that seizures are probably less socially accepted than these kinds of memory problems, which he says patients sometimes can pass off as everyday forgetfulness.
For the study, 138 people who had surgery for temporal lobe epilepsy were followed for five years after surgery. A total of 56 percent of those were free of seizures after the surgery. Another 26 percent were free of seizures at either two years after surgery or five years after surgery, but not both. The remaining 18 percent still had seizures at both two and five years after the surgery.
The quality of life scores remained stable for those who still had seizures but did not have any memory problems. Quality of life scores declined only for those who had both seizures and memory problems, which was eight percent of the participants.
Because certain risk factors make people more likely to have memory problems after surgery and other risk factors make people more likely to continue to have seizures after surgery, doctors can use these results to help determine who is a good candidate for surgery and also to closely monitor those who are at risk, Langfitt said.
The study was supported by grants from the National Institute of Neurological Disorders and Stroke and the Agency for Healthcare Research and Quality.
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