Study tracks seizure freedom over thirty years after epilepsy surgery

A new study has shown that 69% of people who undergo brain surgery for epilepsy do not have seizures with impaired consciousness one year later. This figure decreases to 45% at 10 years, 41% at 20 years and 38% at 30 years.

Additionally, 96% have a 50% or greater reduction in seizure days after one year. Although this figure decreases over time, 80% maintain significant seizure reduction over a 30-year period which is thought sufficient to reduce the number of epilepsy deaths. Researchers say the figures show that epilepsy surgery out-performs neuromodulation techniques such as Deep Brain Stimulation, and anti-seizure medication. 

The study was carried out by an international group of researchers including epilepsy experts from the Epilepsy Society’s Chalfont Centre. It is believed to be the longest single-centre follow-up of epilepsy outcomes, tracking over 1,000 people with drug resistant focal epilepsy year on year for up to 33 years. 

Epilepsy surgery can be considered for people with drug resistant focal epilepsy whose seizures persist despite trying two or more anti-seizure medications. 

The postoperative recurrence of seizures suggests that epileptogenic networks in the brain may only be partially addressed by removing the focal point of the seizure through surgery.

Recognition of focal epilepsy as a network disorder may inform a change in surgical strategies that improves long-term outcomes for people with DRE. This may need to combine surgery with other techniques including neuromodulation, in order to maximise seizure reduction and minimise cognitive impact.

Dr Fergus Rugg-Gunn, Clinical Lead at the Epilepsy Society’s Chalfont Centre said: “Brain surgery can offer one of the greatest chances of seizure freedom for the 30-40% of people whose focal epilepsy is not controlled by anti-seizure medications. 

“And yet surgery remains under used with patients often waiting many years before a referral. All patients with focal epilepsy whose seizures do not respond to two or three anti-seizure medications should be considered for surgery as early as possible to give them the greatest chance of a seizure free life.”

If you are considering brain surgery, please read our information: Epilepsy surgery | Epilepsy Society