http://www.cnn.com/2003/HEALTH/conditions/07/28/epilepsy.surgery/index.html

Study to look at early surgery to treat epilepsy

Monday, July 28, 2003 Posted: 10:37 AM EDT (1437 GMT)

(CNN) -- Brain surgery, once considered the treatment of last resort for epilepsy, is showing such promise that doctors may soon be offering it earlier rather than later in the course of the disorder.

"This is surgery to essentially remove the area of the brain that's causing epilepsy," said Dr. Robert Gross, a neurosurgeon at Emory University.

Epilepsy is a disorder affecting more than 2 million Americans and is caused by abnormal surges in the electrical circuits of the brain that result in seizures. More than half of those with epilepsy can live seizure-free by taking medications.

But now a new study is under way to determine just how effective surgery is compared to drug therapy when treating those with temporal lobe epilepsy, the most common form of the disorder.

Typically, about 80 percent of people who have this type of epilepsy surgery will be completely free of all seizures after the surgery, according to Dr. Thomas Henry, director of the Emory Epilepsy Center.

Sponsored by the National Institutes of Health, the trial study will offer half of the 200 participants brain surgery, while the remaining 100 will continue on medications. Both groups then will be monitored for two years to determine which treatment is more effective at eliminating seizures and improving quality of life.

Participants will be people who have had seizures for no more than 2 years and are unable to bring them under control with medications. Most people spend more than a decade trying different drugs before considering surgery, said Emory's Henry.

For someone like Sue Halcomb, the surgery provided a way to get her epilepsy under control. She had her first epileptic seizure when she was 16. Twelve years and many seizures later, she decided to undergo the brain surgery.

"My memory is a little bit worse than what it used to be," Halcomb admitted. "... It has affected it some."

But Halcomb has also been seizure-free for six months and doctors say she has a very good chance of never having a seizure again.

Not all patients respond as well as Halcomb to the surgery, and doctors warn the procedure is not for everyone.

"There is approximately a 1 percent risk of significant disability due to stroke, bleeding or other complications when we look at a large series of patients," Henry said.

For someone like Halcomb, though, the risks of the surgery are worth it.

"I can relax now. I've been through so much, I've not had a seizure, I'm not going to have one," she said. "I'm finally at peace."