A recent prospective study has found out that Neurosurgery for refractory focal epilepsy keeps adults free of seizures for up to 10 years. The study was conducted by Dr. John S. Duncan, of the Institute of Neurology at University College London, and colleagues.
It was found that people were 52 percent free from seizures at five years and 47 percent at 10 years.
During the initial period, the patient gets freedom from even partial seizures that don't impair consciousness. That itself is the strongest predictor of a good long-term outcome, a report said in The Lancet.
Click here to read the report.
As far as a complete cure is considered, only 28 percent seizure-free individuals had discontinued antiepileptic drugs, the report stated.
This finding is expected to offer help in decision-making for patients if they want to continue anti-epileptic drugs, or may be go for a surgery and also improvements in presurgical assessment and surgical treatment of people with chronic epilepsy.
The study results where more than half of the patients remained continuously seizure-free long-term certainly gives more reasons to patients to go ahead with surgery, which has become quite popular once again in the past two decades, they pointed out in an accompanying editorial.
Prior studies have tended to overestimate the number of patients who remain seizure-free after surgery, noted Ahmed-Ramadan Sadek of Southampton University Hospitals and William Peter Gray, MD, of the University of Southampton, England, according to a report in WebMD.
The study was conducted by observing 615 adults, post surgery, prospectively with once a year follow-up for an average of eight years after surgery for refractory focal epilepsy.
Patients free from even simple partial seizures in the first two years after surgery were 2.4-fold more likely to remain free from more serious seizures in the long term (95% confidence interval 1.5 to 3.9).
The longer a person remained seizure-free, the lesser the chances of a relapse.
Most importantly, no patient showed any signs of a worsened condition of epilepsy, post surgery.
The overall proportion of seizure-free patients remained fairly stable at about 70% at any point, but 3% to 15% of patients shifted status in a typical year, said the WebMD report.
Points to be considered in the study are that the study had small numbers of patients in some surgical type groups, and surgical type was not randomly assigned, the researchers cautioned.
Also, small numbers and the observational design of the study limited conclusions on use of anti-epileptic drugs, they added, though noting that if seizures continue after surgery, new drugs could be considered.
The study was funded by the UK Department of Health National Institute for Health Research Biomedical Research Centres funding scheme, the Epilepsy Society and the Dr. Marvin Weil Epilepsy Research Fund.