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The study examined 175 patients with intractable epilepsy who had surgery that removed a small portion of the brain identified as a region involved in seizure generation, and who were seizure-free for the first year following surgery. Researchers followed up with the patients for an average of more than eight years, and found that 63 percent never relapsed.
"Little is known about seizure recurrence in patients five, 10, or 20 years after surgery", said neurologist Susan S. Spencer, MD, of the Yale University School of Medicine. "The number of patients who didn't relapse in this study was larger than we thought it would be."
Among the 65 patients who relapsed, 51 percent had one or fewer seizures per year. A longer seizure-free period indicated that a relapse would be less severe. The remaining patients had more than one seizure per year, and 10 of these patients, who relapsed within four years of surgery, had more than one seizure per month.
Duration of epilepsy before surgery – rather than age at the onset of epilepsy – was a significant factor in predicting seizure freedom. The group who remained seizure-free had epilepsy for an average of almost 16 years prior to surgery. The group who relapsed had epilepsy for an average of more than 20 years prior to surgery.
Seizure freedom is more likely to happen when the tissue removed from the identified brain region is abnormal, Spencer noted. Other factors noted for increasing relapse risk during follow-up included reduced or discontinued anti-epileptic drugs, illness, fatigue, stress or excessive alcohol intake. Thirteen percent of the group who relapsed were off all anti-epileptic drugs and were seizure-free for at least two years before their first relapse.
The study is published in the August 26th issue of Neurology.
MEDICA.de, Sources: American Academy of Neurology