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Early seizures after surgery indicate continuation of epilepsy - research

25 January, 2005

The understanding
that seizures in the weeks after epilepsy surgery were just temporary
due to swelling or minor trauma suffered by the brain during the
operation has been challenged by new research.

Writing in the journal Annals of Neurology, researchers from the University of Melbourne
said that early seizures after the most common form of epilepsy surgery
signal a greatly increased likelihood that the patient will continue to
have seizures.

This
research was the largest to date to indicate that early seizures
following surgery are not all benign, involving 325 people with
epilepsy who underwent temporal lobe removal, the most common form of
epilepsy surgery, which targets the area where seizures commonly begin.

The
study found that patients who within four weeks of the operation
experienced a seizure where the trigger was not trauma or swelling
caused by the surgery were eight times more likely to have persistent
epilepsy several months later. Even among the patients with evidence of
these triggers there was a three-fold increase in the likelihood of
continuing epilepsy.

Lead author Anne McIntosh said:

'Given
that surgery is only performed in cases where the disease is
debilitating, these results do not cast doubt on the procedure itself.
Many subjects who have a return of epilepsy still have ongoing benefit
from the procedure in terms of reduced seizure frequency.'

She added:

"These
findings have implications for patient counselling, but they are also
interesting in terms of understanding epilepsy. We can speculate that
some individuals who undergo this procedure have epilepsy that for some
reason is more persistent."