Outcome of European study: the sooner epilepsy surgery, the better the result
A large-scale European study into the effectiveness of epilepsy surgery, led by the UMC Utrecht and the University Hospitals of Erlangen, convincingly shows its success. One year after surgery, 72% of patients with epilepsy are seizure-free. After two years, that percentage is still 68% and after five years 66%. The results help in deciding whether surgery to treat epilepsy is effective. The findings also support the idea that operating as quickly as possible improves the outcome. This study was published in the Lancet Neurology on August 18.
The European Epilepsy Brain Bank study examined 9,147 patients who underwent surgery between 2000 and 2012. The study looked at whether and how long the patients are seizure-free after the operation, as well as at the difference in outcome between the different causes of epilepsy. For example, 78% of patients who had epilepsy as a result of a tumor were seizure-free after surgery. For epilepsy patients with certain predispositions of the cerebral cortex, this percentage was considerably lower at 50%.
Professor of pediatric neurology at the UMC Utrecht and research leader Kees Braun says, “The study clearly shows that the sooner you operate, the greater the chances of success. For a patient with epilepsy caused by a vascular lesion, for example, the chance of becoming seizure-free after surgery within one year is 85%. However, if you do not operate until after twenty years, that chance is reduced to 70%. That is another argument to operate at an early stage. Yet another argument for early surgery is that patients need medication for a smaller period of time. The study also shows that in children the medication is much more often phased out after five years than in adults, which benefits their development.”
The results can be taken into account when considering treatment for epilepsy. Kees says, “Epilepsy surgery removes the source of epilepsy from the brain. This is only possible if no important brain functions are lost in the process. In practice, a multidisciplinary team investigates which treatment works best for which patient. These study results can be taken into account in that decision.”
This is the third publication on applied epilepsy research of the research group in the Lancet Neurology . The first showed that after epilepsy surgery, children could safely reduce their medication at an early stage. The second describes an online prediction model that can be used to calculate the risk of reducing medication for each individual. Kees is particularly pleased with these publications because they can improve the care for epilepsy patients worldwide. “These types of results are only possible because we receive the data from a great many hospitals. Close European cooperation forms the basis for this study.”
The European Epilepsy Brain Bank study is a European collaboration and part of the European Reference Network Epicare. The UMC Utrecht and the Erlangen University Hospitals have studied the outcomes of more than 9,000 epilepsy patients from 37 centers in 18 countries.