Newly developed brain surgery can permanently repair epilepsy

New study proves groundbreaking success in the fight against epilepsy

A recent study of 10,000 examined patients proves the success of brain surgery used in epilepsy patients who are not seizure-free by medication. Leading German neuropathologists, neurologists and neurosurgeons report in the study on the conditions and chances of success of the promising operation.

People who suffer from epileptic seizures have severe limitations in everyday life. The seizures come most unexpectedly. Many sufferers have no memory of the seizures and are completely helpless. The disease has many faces. It manifests itself in sensory disorders or twitching of an arm or leg without restriction of consciousness, over seizures with consciousness clouding and uncontrollable actions, to cramps and twitching of the whole body. Epilepsy is one of the most common chronic diseases affecting the brain. Five to ten percent of all people experience at least one epileptic seizure in their lives. If these attacks occur more frequently, it is called epilepsy. Can a brain operation permanently help those affected??

The cut for a better quality of life

The prestigious journal "The New England Journal of Medicine" published the current study, which evaluated the data of just under 10,000 patients who underwent the said brain surgery. The results are promising. On average, seizure freedom was achieved in six out of ten patients, although prior drug treatment was unsuccessful. A prerequisite for the success of the procedure is, according to the study, a secure identification of the brain region from which the seizures emanate. This brain region is then completely removed by the surgical procedure.

A change in the conventional treatment is required

Due to the success of the study, the German Society of Neurology (DGN), the German Society for Epileptology (DGfE) and the German Society for Neuropathology and Neuroanatomy (DGNN) are now calling for rethinking the treatment of epilepsy. "Patients who have a high chance of recovery should be identified and operated as early as possible," reports Professor Jörg Wellmer, Head of Ruhr Epileptology at the Department of Neurology of the University Hospital Knappschaftskrankenhaus Bochum and Chairman of the DGfE Imaging Commission.

New opportunities also for children suffering from epilepsy

On average, patients are given medication for 16 years before surgery is considered. But three-quarters of all epilepsies begin as early as childhood. For these children, many professional and social perspectives are lost if surgery is considered as the last treatment option after the failure of any drug therapy, the DGN reports. The results of the study, however, show other approaches, because 65 percent of operated children were seizure-free after the procedure. For adults, the success rate was 58 percent.

Last resort operation?

According to the DGN, more than 600,000 patients in Germany suffer from epilepsy. Only in a little more than half of the epilepsy patients with drugs can seizure freedom be achieved. The remaining sufferers are pharmacoresistant. For these patients, epilepsy surgery offers a unique chance to cure epilepsy. "However, many physicians and patients are hesitant because they consider brain surgery only as a last resort," explains Professor Holger Lerche, co-author of the study, board member of the Hertie Institute for Clinical Brain Research and medical director of the Department of Neurology with a focus on epileptology at the University of Tübingen. "Modern surgical techniques make epilepsy surgery in specialized centers a very safe procedure," continues the expert.

Experts demand: Earlier treatment by brain surgery

A patient who does not become seizure-free after treatment with at least two medications in adequate doses is considered to be pharmacoresistant as defined by the 2010 International League Against Epilepsy (ILAE). "At this point, a referral to an epilepsy center should be made to examine the possibility of epilepsy surgery," concludes Professor Lerche. (Fp)