Is Early Surgery the Answer for Epilepsy?

A better way to treat frontal lobe epilepsy

illustration of brain with puzzle piece inside

A Cleveland Clinic study has found that early brain surgery for frontal lobe epilepsy may be more successful in controlling seizures than medications.

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Frontal lobe epilepsy is the most complex form of epilepsy to treat. Many epilepsy patients take medications for years to control their seizures. Usually, surgery is only recommended as a last resort after exhausting medication therapy.

The findings suggest that surgery is effective in controlling seizures — and should be done much sooner in treatment.

Cleveland Clinic neurologist Lara Jehi, MD, who led the study, says, “The best thing we can do to avoid further damage is do the surgery to remove the seizure spot as early as possible.”

The promising results of early surgery

Dr. Jehi and her researchers studied the effects of surgery on more than 150 people with frontal lobe epilepsy.

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Some had been taking seizure-control medications for an average of 12 years. Others had only been battling epilepsy for five years or less.

The results showed that nearly 70 percent of the people studied were seizure-free if operated on within five years of the onset of epilepsy. If the surgery was performed later, only 31 percent were free of seizures.

Why an aggressive early approach is best

Dr. Jehi says the most successful patients were younger than 18 who had frontal lobe epilepsy fewer than five years — which suggests taking a more aggressive early approach in treating the disease.

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“The hope is that this will increase people’s awareness that this is a disease that can be cured,” says Dr. Jehi. “We have to be more aggressive in treating it as soon as possible, rather than waiting for decades before we send these patients for a surgical evaluation.”


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