Improvement of Quality‐of‐Life following Resective Surgery for Temporal Lobe Epilepsy: Results of Patient and Family Assessments

Abstract

In order to evaluate the quality‐of‐life (QOL) of epilepsy surgery patients, we surveyed patients' degree of life satisfaction and their families' degree of satisfaction with patient's status in a range of domains both pre‐ and post‐operatively. Of 100 patient‐family sets of surveys that were mailed out, 93 were completed and returned from patients and 91 from their families. All patients surveyed had temporal lobe epilepsy and had been followed for longer than 2 years after resective surgery. Patients and their families rated overall QOL as having markedly improved following surgery. However, they rated social domains of QOL, including role activities, financial status, and social and family relationships as having improved relatively little. Despite freedom from seizures, a few patients' families were dissatisfied with the patients' post‐operative status, primarily for psychosocial reasons. Patients operated on at a later age reported little gains in life satisfaction following surgery. This study supports the conclusion that surgical intervention should occur before patients are subjected to the psychological conflicts and social handicaps associated with chronic intractable epilepsy.

Practice parameter: Temporal lobe and localized neocortical resections for epilepsy

“…Six studies analyzing 521 patients fulfilled the eligibility criteria (see the Appendix on the Neurology Web site) for this analysis. 30,[47][48][49][50] Because studies differed widely in their conceptualization of QOL, methods, QOL instruments, mode of reporting, and patient population, meaningful data pooling was not possible. For this overview, we adopted the authors' own definition of QOL, which encompasses constructs such as patient satisfaction, psychosocial function, and subjectively determined health-related QOL.…”

Epilepsy surgery: Chance for a cure

“…Even though overall quality of life was reported as having markedly improved following surgery, patients operated on at a later age reported little gains in life satisfaction following surgery. Thus, surgery is more successful before patients are subjected to the psychologic conflicts and social handicaps associated with chronic intractable epilepsy [29].…”

Psychosocial and Neurobehavioral Factors Related to Surgical Treatment for Partial Epilepsy: A Multivariate Analysis

“…This was rated both by the clinical interviews and by examination of the case records and is referred to as Psyout1 and Psyout2, respectively. Psyout1 and Psyout2 were subjectively graded relative to preoperative baseline as: excellent, in cases of postoperative resocialization or improved job status (1), moderate (2), and bad, in cases of less appropriate postoperative social interactions or behavioral disturbances necessitating readmission to hospital (3). Similarly, seizure outcome was rated both by the clinical interviews (Seiout1) and in the case records (Seiout2) as: seizure free (including free from auras, for Seiout2) (1), Ͼ90% seizure reduction (2), and Ͻ90% seizure reduction (3).…”

“…Quantified MRI data included preoperative T2 relaxometry values (T2R/T2L), hippocampal volumes (HvolR/ HvolL), and postoperative temporal lobe resection volumes. Amygdala resection volume was also graded on three values: complete resection (1), incomplete resection (2), no resection (3).…”

“…Results from previous studies have suggested that good postoperative seizure control is related to good psychosocial outcome (1,2) and absence of affective disorders or behavioral disturbances (4,5). Right-sided temporal lobectomy may also be considered a risk factor for postoperative emotional or behavioral problems (6).…”