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Epilepsy study: Surgery more effective than medications

April 17, 2012 12:00:00 AM PDT
After strokes, neurologists say epilepsy is the most common serious brain disorder. Many seizures can't be controlled with medication. These folks can't drive or work and eventually they'll lose brain function. New research shows surgery can help. But so few people know it's an option.

It may not look like an epileptic seizure to most people, but it can be just as dangerous.

When 36-year-old John Keener had seizures he would become confused, disoriented and not remember what happened.

"I actually rolled a truck having a seizure, not knowing I had epilepsy at the time," said Keener. "Evidently I said some pretty wild things, did some pretty wild things, evidently I tried getting out of a moving car a couple times."

John's temporal-lobe or limbic seizures don't usually respond to medication.

UCLA professor of neurology Dr. Jerome Engel says John is among the 30 to 40 percent of epileptics whose seizures can't be helped with drugs.

"If you have that kind of epilepsy you're at very high risk for a lifetime of disability and there's a greater than 10 times chance of premature death," said Engel.

The frustration for Engel and his colleagues is that very few patients are ever referred to epilepsy centers. The research shows doctors often keep patients on medications even if they're not working.

"I had to drop out of college. I couldn't drive. I couldn't get to and from school," said Keener.

So Keener participated in a study where half of patients were placed on medication, the other had surgery in which a walnut-sized portion of their brain located above the ear is removed. A two-year follow-up study showed 85 percent of people in the surgery group became seizure-free.

"Whereas the people who didn't get surgery, none of them became seizure-free with the best possible medical treatment," said Engel.

Engel says the study underscores the importance of referring patients to specialized epilepsy centers, such as the one at UCLA.

"The sad truth is that when patients are referred for surgery in this country, it's an average of 22 years after the onset of their epilepsy," said Engel. "It's actually too late."

Keener had his surgery six years ago and he hasn't had a single seizure since. He believes most people with epilepsy don't have to suffer. He agrees with researchers: If you have seizures that are medication-resistant, get to an epilepsy center.

"If you have the opportunity, I would definitely, definitely look into it," said Keener.

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