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8 September 2015

Making epilepsy surgery even safer

New counselling and predictive strategies are helping people with epilepsy to make more informed decisions about whether to undergo epilepsy surgery.

Surgery may be a treatment option for some people whose seizures are drug resistant and for whom neurologists have been able to identify a focal point of their seizures.

However, electing surgery can be challenging. Patients have to weigh up, with their health care team, the potential benefits of surgery against any potential risks.

While surgery may offer the possibility of seizure freedom or a reduction in the severity and frequency of seizures, there may also be a risk that critical brain functions such as memory, language and vision may be adversely affected.

One in three surgery patients may experience some memory decline post surgery, while one in four may have a decline in verbal ability. However, 20 per cent of surgery patients report an improvement in memory post surgery.

Dr Sallie Baxendale, neuropsychologist at Epilepsy Society, said that sensitive tests at the pre-surgery assessment stage enabled them to build up a personalised risk assessment based on the individual’s own characteristics and lifestyle.

'We discuss risks and benefits of surgery and if the person chooses to go ahead we implement any pre-habilitation strategies that may be needed to help them cope with potential cognitive deficits post surgery such as memory decline,’ she told delegates at the 31st International Epilepsy Congress in Istanbul.

‘We can also identify those at most risk of cognitive decline and advise where a risk may be so high that it becomes a cost of seizure freedom.

‘New surgical techniques are really helping to protect language and memory function and our strategies are giving patients the clearest idea possible of their own likely outcome post surgery.’