Surgery Treats Epilepsy Better than Drugs

A study contrasting the use of drugs versus surgical treatment for temporal lobe epilepsy, the most common form of the disease, has found that surgery is the much better treatment. Conducted by researchers from the University of Western Ontario (London, Canada), the study was published in the August 9, 2001, issue of The New England Journal of Medicine.

The study involved 80 patients who found it difficult to control their seizures. The patients were randomized into two groups. One group received the latest epilepsy drugs, while the other group had a surgical procedure in which a small abnormal clump of tissue was excised from the side of the brain where the seizures originated. For one year, they were regularly examined by doctors who did not know which treatment each had received. After one year, only 8% of patients on drug therapy were free of major seizures, compared to 58% of surgery patients. The latter group also reported an improvement in quality of life.

Currently, few patients have the surgery because many doctors consider it too risky and believe it should only be used when absolutely necessary. Unlike other forms of epilepsy, temporal lobe epilepsy, which affects many patients with the disease, can be treated with surgery, whereas drugs fail to control their seizures. Doctors say new brain imaging and surgical techniques have greatly lowered the risk. However, other doctors point out that side effects can include blurred vision, permanent memory loss, and an increased stroke risk. On the other hand, the only patient who died in the study received the drug treatment.