Table 2. Pertinent clinical studies*.
| Author | Type of study | Follow-up | Type of surgery | Outcome variables |
|---|---|---|---|---|
| Rate of freedom from seizures | ||||
| Edelvik et al., 2013 (e8) |
prospective, population-based | 5/10 years | various types of resection |
postoperatively, 62%, vs. 14% under drug treatment |
| Englot et al., 2013 (e9) |
meta-analysis of extratemporal epilepsy surgery in childhood |
variable | extratemporal operations |
postoperatively, 56% (mean) |
| Engel et al., 2012 (2) |
randomized study of epilepsy surgery vs. drug treatment |
2 years | temporal resection (anterior 2/3 resection) |
postoperatively, 73% , vs. 0% under drug treatment |
| Schmidt & Stavem, 2004 (e10) |
meta-analysis | variable | various types of resection |
postoperatively, 44%, vs. 12 % under drug treatment |
| Wiebe et al., 2001 (e11) |
randomized study of epilepsy surgery vs. drug treatment |
1 year | temporal resection (anterior 2/3 resection) |
postoperatively, 58%, vs. 8% under drug treatment |
| Cognitive function | ||||
| Skirrow et al., 2011 (e12) |
prospective, case-controlled | 6 years | temporal resection |
postoperative IQ improvement in surgically treated patients compared to medically treated ones |
| Psychosocial function | ||||
| Smith et al., 2011 (e13) |
prospective, case-controlled (children) |
2 years | temporal and extratemporal resections |
postoperative seizure control led to improvements on scales of depression, anxiety, and disease-related stress |
| Quality of life | ||||
| Hamid et al., 2014 (e14) |
prospective, multicenter cohort study | 5 years | temporal and extratemporal resections |
postoperative seizure control improves the quality of life |
| Mortality | ||||
| Sperling et al., 2005 (e15) |
prospective cohort study | 5 years | resective and disconnecting procedures at various sites |
postoperative freedom from seizures was associated with normalization of mortality, while the mortality of patients with persistent seizures was 5.7 times that of the normal poulation |
*Class I evidence indicates the superiority of resective surgery to continued medical treatment if treatment with two antiepileptic drugs has not led to seizure control. Moreover, successful surgery is associated with improvements in childhood cognitive and psychosocial development and in quality of life (34) and lowers the risk of death due to epileptic seizures (cf. Ref. e7). Comment: Many other studies that are not listed here document the efficacy of the surgical techniques that are mentioned in the text, but not in this table.