Employment and quality of life in mesial temporal lobe epilepsy with hippocampal sclerosis: is there a change after surgical treatment?

Abstract

Purpose: The aim of this study was to evaluate in patients with mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS): (1) employment patterns before and three years after epilepsy surgery and their impact in Quality of Life (QOL); (2) demographic and clinical variables associated with employment. Methods: Data from 58 patients with diagnosis of refractory MTLE with HS who had corticoamygdalohippocampectomy were analyzed. The subjects answered to Brazilian validated version of the Epilepsy Surgery Inventory (ESI-55) before, and three years after surgery. In a semi-structured interview, sociodemographic and clinical characteristics were obtained. Changes in employment after surgery were classified in one of the three categories: (i) improvement status: those who were unemployed, no-formal employed, students, housewives and subjects who have never worked to employed category; (ii) unchanged status: no change in occupation; this category included subjects who were employed before and after the surgery, housewives, students, and the group who remained unemployed, receiving ill-health benefits or retired after the surgical treatment; and (iii) worsened status: loss of employment. Results: Employment status did not show any significant change after surgery: in 51(87.9%) it remained unchanged, in six (10.3%) it improved, and one patient (1.7%), who was employed before the surgery, retired after that. In a subgroup of 22 patients employed after surgery, ten (45.5%) were seizure-free, seven (31.8%) had only rare auras, and five (22.7%) had seizures. In the group of improvement, 12 patients (70.5%) had noformal employment and five (29.5%) had a formal job before surgery. After three years, 14 (63.6%) of 22 subjects were formally employed. Our data suggested that the employability was strongly correlated (p<0.05) with a positive perception of health-related quality of life measured by ESI-55, before and after surgical evaluation. Conclusion: Our study demonstrated in a homogeneous group of MTLE with HS, a modest, but positive relationship between surgical outcome and work gain, and that QOL had strong correlation with the fact of being employed. RESUMO Emprego e qualidade de vida na epilepsia do lobo temporal mesial com esclerose do hipocampo: há uma mudança após a cirurgia?Objetivo: Avaliar o estado empregatício e a qualidade de vida (QV) de indivíduos com epilepsia do lobo temporal mesial (ELTM) com esclerose do hipocampo (EH) antes e três anos após a realização de corticoamigdalohipocampectomia e verificar as variáveis demográficas e clínicas associadas ao emprego. Metodologia: 58 pacientes com ELTM com EH submetidos a corticoamigdalohipocampectomia foram avaliados Endereço para correspondência:

Impact of epilepsy surgery on quality of life: Systematic review and meta‐analysis

“…These were published between 2009 and 2022. Nine studies were of prospective cohort design, [26][27][28][29][30][31][32][33][34] two studies were randomized control trials, 25,35 one was a prospective case-control study, 36 and four were retrospective cohort studies. [37][38][39][40] Two studies reported the same cohort at different follow-up time points (1 year vs. 7.8 years); only the most recently published study was included in the final systematic review and meta-analysis.…”

“…Data were not reported consistently for other patient variables across studies. From the data that were available, mean age at time of study enrollment was 35.2 years, 26,28,29,30,31,33,35,36,38,39 mean age at epilepsy onset was 17.9 years, 25,27,29,31,32,33,38,39,40 mean preoperative seizure frequency was 7.5 seizures per month, 25,27,29,32,34,35,38,39 and mean age at epilepsy surgery was 37.1 years. 25,27,32,33,40…”

“…Six studies (n = 6/16, 37.5%) used QOLIE-31, 27,28,29,32,37,39 four (n = 4/16, 25.0%) used QOLIE-89, 25,26,31,35 three (n = 3/16, 18.8%) used QOLIE-10, 33,34,40 and one (n = 1/16, 6.3%) used ESI-55. 30 Two studies used generic health-related QoL questionnaires: one (n = 1/16, 6.3%) used SF-8, 38 and the other (n = 1/16, 6.3%) used WHOQOL-BREF. 36 One of the four studies used QOLIE-89 in addition to preoperative SF-36 (generic health-related QoL questionnaires) 35 ; however, postoperative SF-36 score was not reported.…”

A Epilepsia Como Doença Incapacitante E Os Critérios Que Impedem O Acesso Dos Epilépticos Ao Auxílio-Doença E À Aposentadoria Por Invalidez No Brasil.

“…Nesse cenário, parte-se da premissa de que a empregabilidade reflete decisivamente na qualidade de vida de um epiléptico (ALONSO et al, 2009), influenciando positivamente o tratamento da epilepsia, razão pela qual estar empregado é, em regra, crucial para o seu progresso. Todavia, no geral, a sociedade brasileira enfrenta o problema de altas taxas de desemprego, mas, em visão micro, aqueles acometidos de doenças crônicas são ainda mais prejudicados (GOMES, 2000).…”

Postoperative Evaluation of the Quality of Life, Depression, and Anxiety of Temporal Lobe Epilepsy Cohort: A Single Institute Experience in Indonesia

“…Surgical intervention for epilepsy has been one of the successful methods for seizure control (3). It is estimated that 52-80% of patients were seizure-free at least for a short time after surgery (4)(5)(6).…”