Early Surgery Can Cure Epilepsy in Children, Study Finds
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iStockphoto/Thinkstock(CLEVELAND) — For the youngest epilepsy patients for whom medication doesn’t work, frontal lobe surgery can stop seizures — in many cases forever — a new study published this week in the Annals of Neurology finds.
Doctors say the brain essentially rewires itself to compensate for the removed lobe or lobes. Where the seizure originates is essentially damaged and so removing it actually helps the health of the brain.
“We have a chance with this surgery to really give people their life back,” said Dr. Lara Jehi, lead study author and director of the Cleveland Clinic Epilepsy Center, where about 100 pediatric surgeries are performed each year.
Researchers reviewed 158 patients who underwent frontal lobe epilepsy surgery from 1995 to 2010. They found that patients who had a shorter duration of epilepsy were almost twice as likely to be seizure-free after surgery.
Epilepsy is a chronic medical condition marked by recurrent seizures, an altered brain function caused by abnormal, excessive or electrical discharges from brain cells.
It affects an estimated three million Americans, or about 1 percent of the population, according to the Cleveland Clinic Epilepsy. About 1 in 4 patients do not respond to medication, and for them, a frontal lobectomy can provide a “cure.”
Those with the worst form of epilepsy — with convulsions and big seizures that include stiffening and shaking — usually have malfunctions in the frontal lobe, according to Jehi.
Those who are resistant to medication are apt to suffer injuries and accidents. They are also three to 12 times more prone to sudden death.
“They go to sleep and never wake up,” she said.
Most epilepsy patients wait decades before being offered surgery and doctors say more might seek this option.
“We found that the mere fact of time — waiting too long before you do surgery — is the most harmful thing you can do to a patient’s brain,” Jehi said.
Patients who have surgery within five years of epilepsy onset have an 80 percent to 90 percent chance of being seizure-free for life, she said.
“If you wait more than five years, it drops to 10 percent,” she said.
Surgery may sound daunting, but Jehi said the mortality rate is less than .02 percent. And the earlier it is done, the better the outcome.
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