How a New Tool Can Help Your Decision About Epilepsy Surgery

A way to accurately gauge the risks and benefits

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Contributors: Elaine Wyllie, MD and Lara Jehi, MD

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Specialized surgery is a promising option for many people experiencing epilepsy who continue to have seizures despite medical treatment.

Epilepsy surgery has significantly improved the lives of many thousands of adults and children worldwide, and experts now routinely consider this option whenever medications have proven ineffective.

But how can patients accurately gauge the potential risks and benefits of the procedure before they decide whether to proceed?

Fortunately, the risks for epilepsy surgery are low, and in fact, research has shown that it’s safer to proceed with surgery than to continue for a lifetime with uncontrolled epilepsy.

Chances for success

Less easily predicted, however, is the likelihood that the surgery will be beneficial. In other words, how likely is the surgery to stop the seizures altogether, when medication did not?

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During the counseling process, doctors typically present patients with the “average” chance of success. Patients would naturally prefer to know the chance for success in their individual case, based on the results in patients similar to them. This information has not generally been readily available to doctors for surgery counseling discussions.

A new tool

A five-year project was recently launched to fill this gap. In June 2017, the National Institutes of Health awarded a $3.4 million grant to Cleveland Clinic to develop a tool to predict individual outcomes in epilepsy surgery. The study, led by Lara Jehi, MD, supports the creation of a comprehensive epilepsy surgery nomogram using diagnostic technology and predictive modeling.

Simply speaking, a nomogram is a two-dimensional diagram designed to perform a specific calculation, much like the mathematical slide rules of the past.

The new epilepsy surgery nomogram will incorporate detailed medical information from 450 patients who already underwent epilepsy surgery, and then be tested in 250 additional patients who are yet to undergo the procedure.

A step toward personalized medicine

Researchers at Cleveland Clinic, Mayo Clinic and University of Campinas will collaborate on the project to generate this first objective, tested, user-friendly epilepsy surgery prediction tool. In the long run, doctors will be able to use this tool to learn from the collective experience of thousands of patients.

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The new epilepsy surgery nomogram, and others like it, represents another step toward personalized medicine that will improve efficiency, outcomes and personal health. If you or your loved one are considering epilepsy surgery, be sure to ask your doctor for the most detailed information available about the likelihood of a successful outcome in your individual case.

This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.


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