More than 2.3 million Americans have epilepsy, and it frequently affects children and young adults in the most critical years of their development. Medication is the most common treatment option with surgery often considered a last resort. Now researchers at the UNM Health Sciences Center are participating in a landmark clinical research study, the Early Randomized Surgical Epilepsy Trial (ERSET), to evaluate these two standard therapies - medications and treatment with surgery and compare the ability of each to eliminate seizures and side effects to improve quality of life.

ERSET is sponsored by the National Institute of Neurological Disorders and Stroke, a part of the National Institutes of Health within the U.S. Department of Health and Human Services.  UNM is one of 18 centers across the country participating in the study.

"The University of New Mexico Comprehensive Epilepsy Program is pleased to join 17 other distinguished epilepsy centers around the country in this important government-sponsored study to find the best early treatment for seizures not cured by antiepileptic medications," said Jerry Shih, M.D., associate professor in the UNM School of Medicine Department of Neurology and UNM's Principle Investigator in the study.  "We hope and anticipate the results of this study will act as a guide for physicians as to the best treatment for certain common seizure types."

Research shows that epilepsy may be progressive in nature, especially in children. As seizures continue they can cause irreversible disturbances in nerve cell function, preventing normal brain development. "Data suggests that seizures can cause memory loss and affect a child's ability to learn and pay attention in school," said Jerome Engel, Jr., M.D., Ph.D., professor of neurology at the David Geffen School of Medicine at UCLA and the principal investigator for ERSET. "Persistence of seizures during adolescence and early adulthood commonly cause irreversible social and psychological consequences."

"This is an important study and we expect that it will answer key questions about treatment choices and the timing of surgical treatment when seizures are difficult to control," said Eric R. Hargis, president and CEO of the Epilepsy Foundation. "Deciding when or whether to continue treatment with medications or to have surgery can be difficult and stressful for people with epilepsy and their families. The results of this study will, we hope, make those decisions easier and in the long run will improve quality of life for hundreds of thousands of patients."

Thirty percent of individuals with epilepsy have seizures that are intractable, meaning their seizures do not respond to medications.  In Mesail Temporal Lobe Epilepsy (MTLE) and seizure intractability may be predicted with a high degree of confidence after two antiepileptic medications have proven ineffective. There are more than 20 antiepileptic medications, and specific therapies often depend on a patient's seizure type and how long they have been having seizures.

Many clinicians remain uncertain about the cost, safety and success rates of surgery and consider it a last resort. The most current data available, which is from 1990, shows that only 2,000 of the 100,000 eligible patients actually underwent the procedure despite the failure of medications to control their seizures. Surgery for MTLE involves the removal of a small amount of brain tissue that is the source of a person's seizures. There have been medical reports, including one published in the August 2, 2001, issue of The New England Journal of Medicine, that purport that surgery is superior to the medical treatment of long-standing MTLE.

ERSET is looking to enroll approximately 200 participants nationally. States. Eligible participants must be at least 12 years old and must also have experienced seizures disruptive to their lives for not more than two years. If they experienced seizures earlier in life that stopped and subsequently re-emerged, they may still be eligible for this clinical research study. In addition, participants must have tried at least two different antiepileptic medications.

ERSET participants will have a complete evaluation to determine if they are eligible for the research study. Eligible participants will be assigned to treatment by surgery with medication or by medication only, and all will receive antiepileptic medications based on the best possible plan designed by epilepsy experts. After two years of follow-up, eligible participants who received medication only will have the option to undergo surgery. Those interested can call 1-505-272-3344.

 


Contact: Cindy Foster, 272-3322