[50 percent of patients who had epilepsy surgery are seizure-free]

Area of Science:

• Neurology
• Neurosurgery
• Clinical Medicine

Background:

• Approximately one-third of epilepsy patients are refractory to medication.
• Resective epilepsy surgery is a primary treatment option for drug-resistant epilepsy.
• Evidence from randomized controlled trials supports epilepsy surgery efficacy in adults and children.

Purpose of the Study:

• To evaluate the long-term outcomes of epilepsy surgery in a large patient cohort.
• To assess seizure control and medication discontinuation rates following epilepsy surgery.
• To emphasize the importance of early referral for epilepsy surgery evaluation.

Main Methods:

• Analysis of data from the Swedish Epilepsy Surgery Register, encompassing nearly 1500 patients since 1990.
• Follow-up assessments of seizure status and medication use post-surgery.
• Inclusion of data from randomized controlled trials on temporal lobe resections and pediatric epilepsy surgery.

Main Results:

• Approximately 50% of adult and pediatric patients achieve seizure freedom two years after surgery.
• An additional 10% experience seizure freedom in the year preceding the two-year follow-up.
• After 10 seizure-free years, 40% of adults and 80% of children discontinue anti-epileptic medication.
• Early referral for pediatric epilepsy surgery is crucial to prevent developmental delays.

Conclusions:

• Epilepsy surgery is an effective treatment for pharmacoresistant focal epilepsy.
• Long-term seizure freedom and medication reduction are achievable outcomes.
• Timely referral to specialized epilepsy teams is critical for optimal patient management and development, especially in children.