Surgical and Social Outcomes
Most surgery patients stay on antiepileptic medications for one to two years after the operation. Some will have to continue with medication indefinitely for the best outcome.
According to the National Institutes of Health, the success rate of lobectomies or cortical resections (no seizures with loss of consciousness) is between 30 and 70 percent, depending on the area removed. Some centers report higher rates. Brief sensory changes (auras) may continue for some years afterwards. The risk of death to lobectomy patients is less than 2 in 100. Complications occur in about 4 of every 100. These may include partial loss of vision, motor ability, or speech. Infection or temporary swelling of the brain may also occur.
Among corpus callosotomy patients the risk of major or minor complications following surgery is around 20 percent. Atonic seizures (drop attacks) generally improve. Other generalized seizures may stop or happen less often. Partial seizures are likely to continue and may even get worse. Centers which perform hemispherectomies report good outcomes. However, there are more risks with this operation than with any other types of epilepsy surgery, and there will be permanent weakness on the side opposite the surgical site. Multiple sub-pial transection has limited data on outcomes.
Although seizures may be greatly reduced or totally controlled following surgery, a number of patients report periods of depression during the adjustment period and it appears that the greatest benefit accrues to those whose seizures are completely controlled. Postsurgical studies of patients’ employment and quality of life show the greatest gains among those who had some employment history prior to the operation and among those whose seizures were completely controlled.