Long‐term health‐related quality of life in drug‐resistant temporal lobe epilepsy after anterior temporal lobectomy

Abstract

Epilepsy surgery is beneficial to patients suffering from drug‐resistant temporal lobe epilepsy in the short term, but fewer reports of long‐term outcomes have been published. To clarify the long‐term outcomes of seizure control and health‐related quality of life after epilepsy surgery, we enrolled 48 patients suffering from drug‐resistant temporal lobe epilepsy. All of the patients received comprehensive presurgical evaluations, including the Quality of Life in Epilepsy Inventory‐89 (QOLIE‐89) questionnaire to measure their health‐related quality of life. Among the patients, 28 patients received surgery (surgical group) and 20 patients remained under medication (medical group). Eight years later, the seizure frequency and QOLIE‐89 were evaluated. The seizure‐free rate was much higher in the surgical group (53.6%) than in the medical group (5%), eight years after the initial evaluation. The follow‐up QOLIE‐89 score was significantly higher in the surgical group than in the medical group. Moreover, the seizure frequency inversely correlated to the QOLIE‐89 score, regardless of the treatment group. Our results provide evidence that epilepsy surgery confers benefits with respect to seizure control and health‐related quality of life for drug‐resistant temporal lobe epilepsy patients based on long‐term follow‐up.

Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study

“…We found a significant improvement in the QOL of our patients with drug‐resistant MTLE‐HS 1 year after ATL. The results are in agreement with several previous controlled and noncontrolled studies using the QOLIE‐31 or other instruments including the Quality of Life in Epilepsy Inventory‐89 (QOLIE‐89), the Epilepsy Surgery Inventory‐55 (ESI 55), the Washington, Psychosocial Seizure Inventory (WPSI), and the Short‐Form Health Survey (SF‐36) . We also replicated a recent Canadian study showing the improvement of QOL after ATL based on the MCIC criteria established for their patients .…”

“…Twenty‐three studies reviewed by Seiam et al . and five additional studies reviewed by us analyzed QOL before and after epilepsy surgery . These studies emphasize the positive impact of epilepsy surgery on QOL by comparing QOL grouped data without exploring clinically important change (CIC) for individual patients and how many individuals reach a CIC in QOL.…”

Health‐related quality of life and emotional well‐being after epilepsy surgery: A prospective, controlled, long‐term follow‐up

“…Many studies are retrospective and have limited follow‐up times or examine patients (and rarely controls) at a single point of time. There are few prospective longitudinal controlled studies of HRQOL after epilepsy surgery and none with a follow‐up of 10 years or more …”

“…There are few prospective longitudinal controlled studies of HRQOL after epilepsy surgery and none with a follow-up of 10 years or more. 2,10,12,[15][16][17] Many studies of HRQOL after epilepsy surgery have focused on statistical significance in change of scores rather than interpreting data in terms of what patients would appreciate as meaningful change. Small changes in HRQOL scores may reach statistical significance, but may not reflect a magnitude of change that is clinically important.…”

Predictive factors of quality of life in temporal and extratemporal lobe epilepsy: association with affective temperament profiles and psychiatric comorbidities

“…Previous reports support our findings that psychiatric status has a stronger effect than disease-related variables on determining QOL 32,33 . In addition, a number of studies have examined the QOL of patients with refractory TLE and documented a significant association between frequent seizures on poorer QOL 34,35 . Our results agreed with those of previous studies where frequent seizures predicted poorer QOL in TLE.…”