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Surgery Offers Some Epileptics Life Expectancy Gains

Those with pharmacoresistant epilepsy may have better quality of life after surgery

TUESDAY, Dec. 2 (HealthDay News) -- Anterior temporal lobe resection can give patients with pharmacoresistant temporal lobe epilepsy longer life expectancy and better quality of life, provided they meet the criteria for surgery, researchers report in the Dec. 3 issue of the Journal of the American Medical Association.

Hyunmi Choi, M.D., of Columbia University in New York City, and colleagues used a simulation model to determine the outcome of surgery on health-related quality of life and life expectancy versus continued medical management of pharmacoresistant temporal lobe epilepsy.

For a 35-year-old patient, anterior temporal lobe resection would give an additional five years' survival versus medical management, the model predicted, and would add 7.5 quality-adjusted life-years to life expectancy. Surgery was the preferred option in 96.5 percent of simulated cases, the researchers report, and was so frequently favored because of the greater number of years free of disabling seizures.

"Studies have reported the effectiveness of temporal lobe resection since the 1950s, yet a minority of patients are being referred to surgery and those only after an average of 20 years of illness. For adolescents and young adults, this delay may be particularly significant during a critical period in their psychosocial development," the authors write. "Referral of patients in a timely manner is crucial, because factors such as older age at surgery and longer duration of epilepsy are associated with a lower likelihood of becoming seizure-free."

The author of the editorial has a financial relationship with the pharmaceutical industry.

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