New study shows breakthrough success in fighting epilepsy
A current study with 10,000 examined patients shows the success of brain operations that are used in epilepsy patients who are not seizure-free with medication. Leading German neuropathologists, neurologists and neurosurgeons report in the study on the prerequisites and chances of success of the promising operation.
People who suffer from epileptic seizures have severe limitations in everyday life. Most of the seizures come unexpectedly. Many sufferers have no memory of the seizures and are completely helpless. The disease has many faces. It manifests itself in emotional disturbances or twitching of an arm or leg without restricting consciousness, seizures with diminished consciousness and uncontrollable actions up to spasms and twitches of the whole body. Epilepsy is one of the most common chronic diseases that affect the brain. Five to ten percent of all people experience at least one epileptic seizure in their life. If these attacks occur more often, one speaks of epilepsy. Can brain surgery permanently help those affected?
The cut for a better quality of life
The renowned journal "The New England Journal of Medicine" published the current study, which evaluated the data of almost 10,000 patients who underwent the brain surgery. The results are promising. On average, six out of ten patients achieved a seizure-free experience, even though drug treatment had not been successful beforehand. According to the study, the prerequisite for the success of the procedure is reliable identification of the brain region from which the seizures originate. This region of the brain is then completely removed by the surgical intervention.
A rethink in conventional treatment is required
Due to the success of the study, the German Society for Neurology (DGN), the German Society for Epileptology (DGfE) and the German Society for Neuropathology and Neuroanatomy (DGNN) are now calling for a rethink in the treatment of epilepsy. "Patients who have a high chance of recovery should be identified and operated on as early as possible," reports Professor Jörg Wellmer, head of Ruhr epileptology at the Clinic for Neurology at the Knappschaftskrankenhaus Bochum University Hospital and chair of the DGfE imaging commission.
New opportunities also for children suffering from epilepsy
On average, patients are given medication for 16 years before considering surgery. But three quarters of all epilepsy begins as a child. Many professional and social perspectives are lost for these children if surgery is only seen as the last treatment option after the failure of any drug therapy, reports the DGN. The results of the study, however, show different approaches, because 65 percent of the operated children were free of seizures after the procedure. The adult success rate was 58 percent.
Last resort surgery?
According to the DGN, more than 600,000 patients in Germany suffer from epilepsy. Only a little more than half of the epilepsy patients could be relieved of medication with medication. The rest of those affected are pharmacoresistant. For these patients, epilepsy surgery offers a unique opportunity to cure epilepsy. "However, many doctors and patients are hesitant because they only consider brain surgery to be a last resort," explains Professor Holger Lerche, co-author of the study, board member of the Hertie Institute for Clinical Brain Research and medical director of the Neurology Department with a focus on epileptology at the University of Tübingen. "Modern surgical techniques make epilepsy surgery in specialized centers a very safe procedure," continues the expert.
Experts call for earlier treatment by brain surgery
A patient who does not become seizure-free after attempting treatment with at least two medications in sufficient doses is considered pharmacoresistant according to the definition of the International League against Epilepsy (ILAE) from 2010. "At this point, a referral to an epilepsy center should take place to check the possibility of an epilepsy surgical procedure," concludes Professor Lerche. (fp)