Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
Objective: The objective of this systematic review is to determine whether or not temporal lobe resection cures seizures in epileptics.
Study Design: Systematic review of three English language, peer-reviewed randomized controlled trials, published between 2001 and 2012
Data Sources: Two randomized controlled trials comparing temporal lobe resection surgery to antiepileptic drugs in the treatment of epileptic seizures, and one randomized controlled trial comparing 3.5 cm temporal lobe resection to 2.5 cm temporal lobe resection in the treatment of epileptic seizures. Studies were obtained by the author through the PubMed database.
Outcomes Measured: Primary outcome measured by the three studies was control of seizures, and additional outcomes measured included quality of life and cognitive function.
Results: The three randomized controlled trials found that temporal lobe resection treatment significantly decreased the frequency and severity of seizures in patients with temporal lobe epilepsy that was refractory to pharmacotherapy. Two of the three studies showed that temporal lobe resection resulted in significantly higher rates of freedom from seizures and significantly higher quality of life as compared to treatment with antiepileptic drugs alone. All three studies showed that surgery poses an increased risk of complications and adverse events, including decline in cognitive function.
Conclusions: Data suggests that temporal lobe resection surgery is more effective than medical therapy alone in decreasing the frequency and severity of seizures in patients with temporal lobe epilepsy that is refractory to pharmacotherapy. Temporal lobe resection is not a definitive cure for seizures in epileptics, but research presented in these three studies shows that surgery is superior to pharmacotherapy alone in controlling seizures. Further research is needed to determine long-term efficacy in seizure reduction post-surgically, as well further assessment of cost and safety of temporal lobe resection.
Hall, Alyssa, "Does Temporal Lobe Resection Cure Seizures in Epileptics?" (2016). PCOM Physician Assistant Studies Student Scholarship. 283.