French Study Said to Support Early Surgery
from EpilepsyUSA at "http://www.efa.org/news/epilepsyUSA/surgery.html"
The November issue of Neurology reported that a French study of people with epilepsy shows the condition to be more common than previously thought. The study, by Dr. Frank Semah, involved 2,200 people referred to an epilepsy centre in Paris over 7 years. Most had severe epilepsy or seizures difficult to control with medication. With the help of magnetic resonance imaging (MRI), brain abnormalities in the hippocampus were found in 282 people. Such abnormalities are indicative of mesial temporal lobe epilepsy.
The study has led the president of the International League Against Epilepsy to urge consideration of early surgery in some forms of epilepsy.
In an editorial published in the same issue of Neurology, Dr. Jerome Engel Jr. suggested that "early surgical intervention may prevent irreversible disability" in people with mesial temporal lobe epilepsy. Seizures and their effects become more severe over time with this type of epilepsy. Dr. Engel, a UCLA neurologist, said that 80 to 90% of people with this disorder who undergo surgery become seizure free. "With the new technology in neuroimaging, we can identify these patients very easily without using expensive or risky procedures," he added. "And we don't have to try different drug regimens that won't work effectively anyway."
The 282 people with mesial temporal lobe epilepsy identified in the study had the poorest response to medication. Only 11% were seizure free for more than a year.
"Virtually all patients with seizures that are not controlled by 2 or 3 of the most common epilepsy drugs should undergo high resolution MRI evaluations looking for this abnormality," Dr. Engel said.
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