Epilepsy Surgery Outcomes: Quality of Life and Seizure Control

Zupanc, Mary L.; Rubio, Ellianne J. dos Santos; Werner, Rhonda Roell; Schwabe, Michael J.; Mueller, Wade; Lew, Sean M.; Marcuccilli, Charles J.; O'Connor, Sunila E.; Chico, Maria S.; Eggener, Kathy A.; Hecox, Kurt

doi:10.1016/j.pediatrneurol.2009.07.018

Cited by 64 publications

(60 citation statements)

References 31 publications

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“…The temporal resections performed in these patients, specifically in the oldest age group, demonstrated seizure-free outcomes in 76.2%. These results are almost the same as those reported by Meyer et al [29], who demonstrated seizure-free outcomes between 60 and 80%, and Zupanc et al [26] with a seizure-free outcome of 84% in temporal lobectomies. 66.6% of our patients with frontal lobectomies had seizure-free outcomes.…”

Section: Discussionsupporting

confidence: 90%

“…79.5% of our patients demonstrated seizure-free outcomes (Engel I) if patients with corpus callosotomies and vagal nerve stimulation were excluded. It is likely that with a longer follow-up, the outcome values may reduce similar to other series [25,26,27]. Temporal resections were more common in our older adolescent patients, a finding consistent with other studies [21,28].…”

Section: Discussionsupporting

confidence: 90%

“…Previous studies indicated that seizure-free outcomes in young children and adolescents ranged between 59 and 80%. A recent study by Zupanc et al [26] reported an overall seizure freedom of 68.7% (Engel I). 79.5% of our patients demonstrated seizure-free outcomes (Engel I) if patients with corpus callosotomies and vagal nerve stimulation were excluded.…”

Section: Discussionmentioning

confidence: 99%

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Epilepsy Surgery in a Pediatric Population: A Retrospective Study of 129 Children from a Tertiary Care Hospital in a Developing Country along with Assessment of Quality of Life

Dagar¹,

Chandra²,

Chaudhary³

et al. 2011

Pediatr Neurosurg

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Purpose: To assess the outcome of a pediatric population operated for drug-resistant epilepsy from a large tertiary care center in India. Methods: Retrospectively: quality of life (QOL); prospectively: preoperative assessment included interictal EEG, MRI (as per epilepsy protocol), video-EEG. Ictal SPECT (with subtraction) and PET were performed when required. QOL scores were assessed using the HASS or SSQ for seizure severity, Quality of Life in Childhood Epilepsy (QOLCE) for QOL, and Child Behavior Check List (CBCL) for behavior. Results: 142 were operated from January 2000 to June 2011 by the senior author. 118 patients with at least 1 year of follow-up were included in the study. Mean age at surgery was 9.8 ± 4.3 years. In addition, 40 patients underwent QOL assessment prospectively both before and after surgery. Mean duration of epilepsy was 5.3 ± 3.3 years. A class I outcome (Engel’s) was seen in 79.5% patients, class II in 8.6%, class III in 10.7%, and class IV in 1 patient. As per surgical procedures, class I outcome in patients who underwent temporal resection, hemispherotomy and extratemporal resection was 76, 87 and 72%, respectively. QOL scores correlated with duration of seizures, epileptic encephalopathy and outcome of surgery, but not with side of surgery, age and sex. Conclusions: This study, the largest reported from India, has demonstrated satisfactory results for epilepsy surgery in children.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Epilepsy Surgery in a Pediatric Population: A Retrospective Study of 129 Children from a Tertiary Care Hospital in a Developing Country along with Assessment of Quality of Life

Dagar¹,

Chandra²,

Chaudhary³

et al. 2011

Pediatr Neurosurg

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“…All studies reported that epilepsy surgery improved different HRQOL domains in children and adolescents compared to non-operated children and adolescents or healthy controls. However, there were no differences in HRQOL between adolescents who were and who were not seizure free after surgery (Zupanc et al, 2010). No differences were found between children and adolescents (Van Empelen et al, 2005), while seizure outcome (seizure freedom) and baseline levels of functioning strongly predicts HRQOL in this population (Sabaz et al, 2006).…”

Section: Impacts Of Epilepsy Surgery On Hrqolmentioning

confidence: 78%

“…Five studies, two follow-ups, evaluated HRQOL in children and adolescents with symptomatic epilepsy who underwent epilepsy surgery (Van Empelen et al, 2005;Sabaz et al, 2006;Mikati et al, 2008;Mikati et al, 2010;Zupanc et al, 2010). All studies reported that epilepsy surgery improved different HRQOL domains in children and adolescents compared to non-operated children and adolescents or healthy controls.…”

Section: Impacts Of Epilepsy Surgery On Hrqolmentioning

confidence: 99%

Health-Related Quality of Life in Children and Adolescents with Epilepsy: A Systematic Review

Stevanović¹,

Tadić²,

Novakovic³

2011

Epilepsy in Children - Clinical and Social Aspects

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Trajectory of Health-Related Quality of Life After Pediatric Epilepsy Surgery

et al. 2023

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ImportanceHealth-related quality of life (HRQOL) is regarded as a key outcome for evaluating treatment efficacy. However, it is uncertain how HRQOL evolves after epilepsy surgery compared with medical therapy, such as whether it continues to improve over time, improves and then remains stable, or deteriorates after a period of time.ObjectiveTo assess trajectory of HRQOL over 2 years in children with drug-resistant epilepsy (DRE) treated with surgery compared with medical therapy.Design, Setting, and ParticipantsProspective cohort study assessing HRQOL longitudinally over 2 years. Participants were children recruited from 8 epilepsy centers in Canada from 2014 to 2019 with suspected DRE aged 4 to 18 years who were evaluated for surgery. Data were analyzed from May 2014 to December 2021.ExposuresEpilepsy surgery or medical therapy.Main Outcomes and MeasuresHRQOL was measured using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE)-55. HRQOL and seizure frequency were assessed at baseline, 6-month, 1-year, and 2-year follow-ups. Clinical, parent, and family characteristics were assessed at baseline. A linear mixed model was used to evaluate HRQOL over time, adjusting for baseline clinical, parent, and family characteristics.ResultsThere were 111 surgical and 154 medical patients (mean [SD] age at baseline was 11.0 [4.1] years; 118 [45%] were female). At baseline, HRQOL was similar among surgical and medical patients. HRQOL of surgical patients was 3.0 (95% CI, −0.7 to 6.8) points higher at 6-month, 4.9 (95% CI, 0.7 to 9.1) points higher at 1-year, and 5.1 (95% CI, 0.7 to 9.5) points higher at 2-year follow-ups compared with medical patients. Surgical patients experienced greater improvements in social functioning relative to medical patients, but not for cognitive, emotional, and physical functioning. At 2-year follow-up, 72% of surgical patients were seizure-free, compared with 33% of medical patients. Seizure-free patients reported higher HRQOL than those who were not.Conclusions and RelevanceThis study provided evidence on the association between epilepsy surgery and children’s HRQOL, with improvement in HRQOL occurring within the first year and remaining stable 2 years after surgery. By demonstrating that surgery improved seizure freedom and HRQOL, which has downstream effects such as better educational attainment, reduced health care resource utilization, and health care cost, these findings suggest that the high costs of surgery are justified, and that improved access to epilepsy surgery is necessary.

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Epilepsy Surgery Outcomes: Quality of Life and Seizure Control

Cited by 64 publications

References 31 publications

Epilepsy Surgery in a Pediatric Population: A Retrospective Study of 129 Children from a Tertiary Care Hospital in a Developing Country along with Assessment of Quality of Life

Epilepsy Surgery in a Pediatric Population: A Retrospective Study of 129 Children from a Tertiary Care Hospital in a Developing Country along with Assessment of Quality of Life

Health-Related Quality of Life in Children and Adolescents with Epilepsy: A Systematic Review

Trajectory of Health-Related Quality of Life After Pediatric Epilepsy Surgery

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