Controversial surgery benefits epileptics.It's an operation bracketed by question marks. The first question mark is the contour of the initial incision. Just above the ear, it permits doctors to lay bare to make bare; to strip. - Bacon. See also: Lay the brain and snip away troublesome nerve circuits that trigger epileptic seizures. The second question mark is less literal but more compelling: Does the surgery benefit the patient? In scores of patients who have had the surgery-known as anterior temporal lobectomy-during the last 40 years, the answer has appeared to be yes. Yet no studies had comprehensively measured the surgery's impact on patients' lives. Now, research by doctors at the University of Pennsylvania (body, education) University of Pennsylvania - The home of ENIAC and Machiavelli. http://upenn.edu/. Address: Philadelphia, PA, USA. in Philadelphia has remedied that lack. The study, which followed patients for 5 years after surgery, found that removing a small amount of brain tissue eliminated seizures in 62 of 89 people who had suffered severe, frequent seizures for years. Eighteen of these patients were able to stop taking anticonvulsant medication Anticonvulsant medication A drug used to prevent convulsions or seizures; often prescribed in the treatment of epilepsy. Several anticonvulsant medications have been found effective in the treatment of bipolar disorder. Mentioned in: Bipolar Disorder . The surgery eliminated up to 80 percent of seizures in another 18 individuals, 8 of whom subsequently had seizures on fewer than 2 days a year or seizures that occurred only at night. "The effectiveness of the surgery extends well beyond helping with seizures," says Michael R. Sperling, a neurologist at the university and an author of the report in the Aug. 14 Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. . "Epilepsy surgery saves lives." Some people with epilepsy It may never be fully completed or, depending on its its nature, it may be that it can never be completed. However, new and revised entries in the list are always welcome. <onlyinclude> This is a list of notable people who have, or had, the medical condition epilepsy. die young for unknown reasons. There were no deaths during the study among the people who remained free of seizures. Some of the others didn't fare as well. "Four of those who continued having seizures were dead 5 years after surgery," says Sperling. Surgery is recommended only for people whose seizures persist despite drug therapy and whose damaged brain circuitry is confined to a single region. In most cases, that region lies within one of the temporal lobes. These protrusions on either side of the cerebral cortex cerebral cortex Layer of gray matter that constitutes the outer layer of the cerebrum and is responsible for integrating sensory impulses and for higher intellectual functions. are situated above the ear and behind the eye. The right temperal lobe holds spatial memories, such as shapes and faces; the left contains verbal memories. Because the boundaries of these memory regions are imperfectly charted, however, cutting into the temporal lobe presents risks. "I've never had a death in 500 temporal lobectomies," says Michael J. O'Connor, a neurosurgeon neurosurgeon a physician who specializes in neurosurgery. neurosurgeon A surgeon specialized in managing diseases of the brain, spine and peripheral nerves Meat & potatoes diseases Brain tumors, spinal cord disease Salary $245K + 15% bonus. at the university. But he reports that improper insertion of an electrode into the brain paralyzed par·a·lyze tr.v. par·a·lyzed, par·a·lyz·ing, par·a·lyz·es 1. To affect with paralysis; cause to be paralytic. 2. To make unable to move or act: paralyzed by fear. one of his patients, and several have complained of diminished memory. "I certainly have unhappy patients-and a lawsuit to prove it," says O'Connor, who speaks out about the risks of the surgery because he believes people should make informed decisions. The study found that the benefits of the surgery often extend into many aspects of a person's life. Before the surgery, 24 percent of patients were unemployed; 5 years after surgery, that figured had dropped to 11 percent. Those who no longer had seizures were able to drive, socialize so·cial·ize v. so·cial·ized, so·cial·iz·ing, so·cial·iz·es v.tr. 1. To place under government or group ownership or control. 2. To make fit for companionship with others; make sociable. , and live independently, Sperling says. O'Connor likens the surgery to a battle. "After the war, these patients have won their independence." He adds, "There are none missing. Remarkably few have big scars." Barbara G. Vickrey of the University of California, Los Angeles UCLA comprises the College of Letters and Science (the primary undergraduate college), seven professional schools, and five professional Health Science schools. Since 2001, UCLA has enrolled over 33,000 total students, and that number is steadily rising. says her study of 248 patients, published in the Dec. 2, 1995 Lancet, revealed similar benefits in the first 5 years after the surgery. Though her study depended on a review of medical records rather than direct observation of patients, she found that many patients who had suffered epileptic seizures for more than a decade improved after surgery. Vickrey says these people should have been referred for surgery years earlier. |
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