June 4, 2007 / 8:42 PM / 11 years ago

Seizure status after surgery key to quality of life

NEW YORK (Reuters Health) - People with temporal lobe epilepsy experience stable or improved quality of life after successful surgery to control their seizures, even if they develop some degree of memory decline, a new study shows.

But if the surgery doesn’t eradicate seizures and memory loss develop, patient experience s a decline in health-related quality of life, Dr. John T. Langfitt of the University of Rochester in New York and colleagues report.

It’s possible that people have an easier time compensating for memory loss, for example by keeping lists, than coping with the handicapping effects of seizures, Langfitt and his colleagues suggest in their report, published in the June 5th issue of Neurology. “Memory problems are also less likely than seizures to invite social stigma that can reduce role functioning,” they add.

The study included 138 patients with temporal lobe epilepsy with did not respond well to drug treatments. Langfitt and his team followed the patients who underwent surgery to the temporal lobe, the area of the brain where the seizures originated.

Eighty-two percent became seizure-free and remained so 2 to 5 years after the surgery and 36 percent experienced some degree of memory loss.

Among the 25 patients (18 percent) who continued to have seizures, 11 (8 percent of the total) also suffered from memory loss. The other 14 patients (10 percent) remained stable and did not develop memory loss.

All of the seizure-free patients reported improved quality of life after the surgery. For patients who continued to have seizures but didn’t have memory problems, quality of life was unchanged, but those who still had seizures and memory loss reported a decline in quality of life.

These findings can be used to counsel patients on what to expect after epilepsy surgery, given that it is possible to predict which patients will experience such problems, the researchers note.

For example, if the surgery will affect the half of the brain that controls speech, verbal memory loss is more likely. People who have had no memory loss before surgery are more likely to experience it afterwards.

In an editorial accompanying the study, Dr. Gregory D. Cascino of the Mayo Clinic in Rochester, Minnesota notes that even epilepsy patients with uncontrollable seizures who are at high risk of memory loss should be considered for the surgery, “earlier rather than later...because rendering the individual seizure free is required to be a participating and productive member of society.”

SOURCE: Neurology, June 5, 2007.

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