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Jefferson researchers find timing of post-epilepsy surgery seizures predicts outcome

Timing often matters when it comes to epileptic seizures that can occur after surgery designed to stop them. A multicenter study led by researchers at Jefferson Medical College has found that patients who had an initial seizure within the first four months of surgery were less likely to do as well in the long term as those individuals who did not.

"A patient has surgery to remove some brain tissue, hoping to cure his epilepsy, and has a seizure a week or a month or a year later, and wonders, 'What does this mean? Has surgery failed?'" says Daniel H. Parish, a second-year medical student at Jefferson Medical College of Thomas Jefferson University in Philadelphia, who is the lead author of the report. "We wanted to know if the timing of seizures after surgery was related to long-term outcome." He reports the study findings April 13, 2005 at the annual meeting of the American Academy of Neurology in Miami Beach.

Mr. Parish, Michael R. Sperling, M.D., Baldwin Keyes Professor of Neurology at Jefferson Medical College of Thomas Jefferson University and director of the Jefferson Comprehensive Epilepsy Center, and their colleagues at six other medical centers studied 387 patients who had epilepsy surgery, following these patients for an average of 4.4 years. Although about two-thirds of patients experienced at least one seizure some time after surgery, a similar percentage ultimately stopped having seizures.

They broke down patients into five groups: those who had seizures within one month of surgery, one month to four months, four months to one year, one year to three years, and after three years post-surgery, asking if the length of time to the first seizure mattered to the individual's prognosis.

"The evidence shows that having the first seizure within the first four months bodes worse for prognosis," Mr. Parish says.

"If the person had his first seizure in say two months post-surgery, there is a reduced chance he will remain free of s
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13-Apr-2005


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