Most patients who undergo brain surgery for epilepsy satisfied with choice, study suggests

A survey of over 400 patients who received brain surgery to treat epilepsy has revealed that a majority were satisfied 15 years after deciding to undergo the procedure.

The study, conducted by physicians at Henry Ford Hospital in Detroit, asked patients whether they could start driving and working again, and whether they took antidepressants after their surgery. The study participants had a portion of their brains surgically removed or resected to treat localization-related epilepsy at Henry Ford during an 18-year period.

Study authors say the survey is one of the first to assess long-term satisfication with the operation.

"Most previous studies looked at seizure and psychosocial outcomes at two to five years after surgery, and a few for up to 10 years," lead author Dr. Vibhangini S. Wasade, a neurologist at Henry Ford, said in a news release.  "We aimed to assess the long-term outcomes— up to 15 years— at our epilepsy center."

Of the 420 total patients surveyed by phone, 92 percent reported that their epilepsy surgery was worthwhile, according to the news release. Thirty-two percent said they were seizure-free, and 75 percent said they had favorable results.

Researchers learned that 51 percent of those patients surveyed were able to drive a car after their surgery, compared to 35 percent before the procedure.

But compared to before surgery, patients were more likely to be taking antidepressant medication and less likely to be working full time.

"This could be due to relative aging of the surveyed patients, who were comparatively older and undergoing surgery at a later age,” Wasade said. “About seven percent were retired, and 35 percent were not employed for reasons other than seizures."

Wasade attributed the increase in antidepressant use to other ongoing illness, depression as a side effect of anti-epilepsy drugs, or doctors’ improved detection of epilepsy-related depression. He said hard economic times could have contributed to patients’ inability to work after the surgery.

According to the National Institutes of Health (NIH), doctors may recommend a patient be evaluated for surgery when his or her seizures cannot be controlled well by medications. To determine whether this option is appropriate for an epilepsy patient, doctors consider the types of seizures the person has, and they also take into account the affected brain region.

Doctors typically avoid operating in areas of the brain that are necessary for speech, language, hearing or other important functions, according to the NIH.  If a patient has tried two or three different medications without success, or if there is an identifiable brain lesion defined as a damaged or poorly functioning area of the brain, then doctors will usually recommend this option for epilepsy treatment.

The study was published in the February issue of the journal Epilepsy & Behavior.