Brain surgery is associated with a reduction in mortality rate in drug-resistant epilepsy, both when seizures are abolished and when it results in significant palliation of tonic-clonic seizure frequency, a recent study found. Researchers evaluated a total of 1,110 patients (1,006 surgically and 104 non-surgically treated) for a total follow-up of 8,126.62 person-years from 1986 to 2013. Deaths were ascertained through database and Social Security Death Index query. Patients were grouped by surgery type and seizure status; standardized mortality ratio and deaths per 1,000 person-years were calculated. They found:

• 89 deaths were observed.

• Surgically treated patients had a lower mortality rate (8.6 per 1,000 person-years) than non-surgically treated patients (25.3 per 1,000 person-years).

• Seizure-free patients have a lower mortality rate (5.2 per 1,000 person-years) than non-seizure-free patients (10.4 per 1,000 person-years).

• More frequent post-operative tonic-clonic seizures (>2 per year) were associated with increased mortality whereas complex partial seizure frequency was not related to death rate.

• Mortality was similar in temporal and extratemporal epilepsy patients.

Citation: Sperling MR, Barshow S, Nei M, Asadi-Pooya AA. A reappraisal of mortality after epilepsy surgery. [Published online ahead of print April 27, 2016]. Neurology. pii:10.1212/WNJ.0000000000002700.