Brain surgery can prevent epileptic seizures
Team of researchers at FAU and University Medical Centre Utrecht assesses European cohort of more than 9000 operations.
The World Health Organisation classes epilepsy as a common and serious brain disease. One third of all patients do not respond to drugs-based treatment. In the case of focal epilepsy, where the cause is located in a certain area of the brain, brain surgery can be beneficial and can even act as a cure. This has now been shown by a team of researchers from Universitätsklinikum Erlangen at Friedrich-Alexander-Universität Erlangen-Nürnberg and the University Medical Centre in Utrecht. Based on 9,000 patients from 37 epilepsy centres in 18 European countries, they investigated the short, medium and long term success of epilepsy surgery and the use of medication after surgery. The results have been published in the scientific journal Lancet Neurology.
Within the context of the EU-funded ‘European Epilepsy Brain Bank Consortium’, the team led by Prof. Dr. Ingmar Blümcke from FAU and Prof. Dr. Kees Braun from the University Medical Centre Utrecht investigated the outcome of epilepsy surgery carried out at 37 European epilepsy centres between 2000 and 2012: Did the patients still suffer from seizures after surgery? How long did successful treatment last? Did the patients still require drugs after surgery or could they do without them?
The outcome was that epilepsy surgery has a high rate of success. 72 percent of patients were seizure-free one year after surgery. After two years it was 68 percent and after five years 66 percent. The success of neurosurgery also depends on changes in brain tissue in the area causing the epileptic seizures: if the epilepsy was caused by a benign brain tumour, malformed blood vessels or a loss of nerve cells in the hippocampus, more than 70 percent of patients were seizure-free after two years, whilst in the case of patients where no microscopic changes could be detected in the area of the brain removed by surgery, this was the case approximately 50 percent of the time. After five years, 45 percent of children and 28 percent of adults were able to stop taking their epilepsy medicine entirely. ‘After this period of time, we can basically talk of the disease being cured,’ commented Prof. Ingmar Blümcke. The longer the patient has suffered from epilepsy, however – from the first seizure until the date of surgery – reduced the chances of becoming entirely seizure-free. ‘Our study does not only prove that epilepsy can be successfully treated by surgery. It also gives us a tool we can refer to when advising patients who are considering surgery,’ says Prof. Blümcke.
The ‘European Epilepsy Brain Bank Consortium’ is part of the European Reference Network ‘EpiCARE’.
Further information:
Doi: https://doi.org/10.1016/S1474-4422(20)30220-9
Contact:
Prof. Dr. Ingmar Blümcke
Chair of Neuropathology
Phone +49 9131 85 26031