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JMERRAND on Surgery for Epilepsy

JMERRAND on Surgery for Epilepsy

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Published by June Veintidos
This paper was written in Fall of 2007 during my first trimester at Pepperdine University, The George L. Graziadio School of Business and Management .
This paper was written in Fall of 2007 during my first trimester at Pepperdine University, The George L. Graziadio School of Business and Management .

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Published by: June Veintidos on Jan 15, 2011
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04/29/2012

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Working Paper & Decision Tree:
A comparison between surgery for temporal lobe epilepsyand changed medicationsDecember 3, 2007Jennifer Errande
Page 1 of 14Errandes Working PaperSaturday, January 15, 2011
 
Background
Epilepsy has a prevalence of 5 to 10 per 1000 in North America. Seizures inTemporal Lobe epilepsy can be very disabling to people who are otherwise healthyI was diagnosed with temporal lobe epilepsy in 1976, at the age of 2. Iunderwent surgery for temporal lobe epilepsy at Cedars Sinai Medical Center onWednesday, June 22, 2005 and have had no seizures since. I took my lastmedication in January of this year.25,000 to 50,000 people will die of seizure related causes each year in theUnited States. The average indicates that approximately 102.7 people die fromseizure related causes every day. Approximately 91711 people in the United Stateshave died from seizure related causes since the day of my surgery.Surgical treatment of temporal lobe epilepsy was compared to medicaltreatment at the London Health Sciences Centre, Univeristy of Western Ontario,Canada between July 1996 and August 2000. 58 percent of the surgical patientswere free of seizures, compared to only 8 percent of the medical group patients. 40 patients were assigned to each group.Only 4 (10 percent) of the surgical patients had adverse effects of surgery.Only two of those patients (5 percent of the entire surgical group) had effects ontheir verbal memory which interfered with their occupations. It is estimated thatonly 1500 of the nearly 100,000 eligible patients undergo surgical procedures eachyear [1].The median percentage improvement in the monthly frequency of seizureswas 100 percent in the surgical group and 34 percent in the medical group.
Problem Description and Discussion of Data
Page 2 of 14Errandes Working PaperSaturday, January 15, 2011
 
Since the medical community has come to see surgery as a preferredtreatment for TLE, the primary purpose of this paper is to convince patients toundergo surgery for temporal lobe epilepsy when advised to do so by their  physician.To simplify the process, I have designed a decision tree which can be shownto the patient. The primary purpose of the decision tree is to demonstrate thatsurgery for temporal lobe epilepsy is not as risky as many believe it to be. I haveformatted the tree to also demonstrate that, in fact, a life with uncontrolled epilepsyis far riskier.In this decision tree, the cells which would normally display cash flows willdisplay changes in one’s quality of life. For the purpose of this decision tree, Ihave chosen to create a formula which would allow a patient to rate five elementsof their life on a scale from 1 to 10, allowing for decimals. Allowing the patient toscore their quality of life in the decision tree will make them feel that they are participating in the calculations, and will help them accept the outcomes as beingvalid. The values will be doubled and summed up, so that the maximum possiblevalue would be 100.The five elements which the patient will rate are health, material well-being,family life, community life with political stability, and job security[5].For example, let’s assume that a patient with uncontrolled epilepsy ratedeach element of their life as follows:Health=4.5Material well-being=6.3Family life=4.8Community life with Political stability=2.4Job security=0
Page 3 of 14Errandes Working PaperSaturday, January 15, 2011

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