Surgery Helps Reduce Epileptic Seizures When Drugs Fail

Result should be interpreted with caution due to small number of enrollees

TUESDAY, March 6 (HealthDay News) -- Temporal resection surgery reduces the probability of seizures in patients with treatment-resistant epilepsy, compared with continued antiepileptic drug (AED) treatment, according to a study published in the March 7 issue of the Journal of the American Medical Association.

Jerome Engel Jr., M.D., Ph.D., from the University of California in Los Angeles, and colleagues analyzed data from 38 participants with mesial temporal lobe epilepsy (MTLE) and disabling seizures for no more than two consecutive years, following failure of trials of two brand-name AEDs. Anteromesial temporal resection (AMTR) eligibility was based on a standardized presurgical evaluation protocol. Participants were randomized to continued AED treatment (23 patients) or AMTR (15 patients), and were observed for two years. Due to slow accrual of patients, the trial was halted prematurely. Health-related quality of life was measured by the Quality of Life in Epilepsy 89 (QOLIE-89) overall T-score.

The researchers found that, during two years of follow up, none of the participants in the medical group and 11 in the surgical group were seizure free The mean improvement in QOLIE-89 overall T-score was higher in the surgical group than in the medical group, but the difference was not statistically significant (P = 0.08).

"Among patients with newly intractable disabling MTLE, resective surgery plus AED treatment resulted in a lower probability of seizures during year two of follow-up than continued AED treatment alone," the authors write. "Given the premature termination of the trial, the results should be interpreted with appropriate caution."

Several authors disclosed financial ties to pharmaceutical and medical device companies.

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