Controversial Surgery Benefits Epileptics

By Sternberg, Steve | Science News, August 17, 1996 | Go to article overview

Controversial Surgery Benefits Epileptics


Sternberg, Steve, Science News


It's an operation bracketed by question marks.

The first question mark is the contour of the initial incision. Just above the ear, it permits doctors to lay bare the brain and snip away troublesome nerve circuits that trigger epileptic seizures. The second question mark is less literal but more compelling: Does the surgery benefit the patient? In scores of patients who have had the surgery-known as anterior temporal lobectomy-during the last 40 years, the answer has appeared to be yes. Yet no studies had comprehensively measured the surgery's impact on patients' lives.

Now, research by doctors at the University of Pennsylvania in Philadelphia has remedied that lack. The study, which followed patients for 5 years after surgery, found that removing a small amount of brain tissue eliminated seizures in 62 of 89 people who had suffered severe, frequent seizures for years. Eighteen of these patients were able to stop taking anticonvulsant medication.

The surgery eliminated up to 80 percent of seizures in another 18 individuals, 8 of whom subsequently had seizures on fewer than 2 days a year or seizures that occurred only at night.

"The effectiveness of the surgery extends well beyond helping with seizures," says Michael R. Sperling, a neurologist at the university and an author of the report in the Aug. 14 Journal of the American Medical Association. "Epilepsy surgery saves lives."

Some people with epilepsy die young for unknown reasons. There were no deaths during the study among the people who remained free of seizures. Some of the others didn't fare as well. "Four of those who continued having seizures were dead 5 years after surgery," says Sperling.

Surgery is recommended only for people whose seizures persist despite drug therapy and whose damaged brain circuitry is confined to a single region. In most cases, that region lies within one of the temporal lobes. …

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