Outcomes in 248 patients who had diagnostic evaluations for epilepsy surgery

Vickrey, Barbara G.; Hays, Ron D.; Rausch, Rebecca; Engel, Jerome; Visscher, Barbara R.; Ary, Catherine M.; Rogers, William H.; Brook, Robert H.

doi:10.1016/s0140-6736(95)92470-1

Cited by 178 publications

(130 citation statements)

References 19 publications

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“…This analysis showed that the score for subjects in the Pre group was lower than that for the Post and control subjects, as reported in the literature, supporting the negative impact of the symptoms on QOL [22][23][24][25]. On the other hand, Post and control subjects differed only regarding the 'self-perception' and 'change' domains, with the Pre group scoring higher than the control group, which indicates a greater influence of surgery on these domains [4,5,25]. O'Donoghue et al [9] determined the discriminant validity of the SHE by evaluating the benefits of epilepsy surgery in a cohort of patients, with results similar to those obtained here.…”

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

Validation of the Subjective Handicap of Epilepsy (SHE) in Brazilian patients with epilepsy

Monteiro

Osório

Alexandre

et al. 2012

Epilepsy & Behavior

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Section: Discussionsupporting

confidence: 77%

“…Quality of life is currently understood as one's perceptions within the framework of values of his culture, including expectations, standards and interests, physical and psychological health, level of independence, sociability, and relations with the environment [3][4][5][6].…”

mentioning

confidence: 99%

Validation of the Subjective Handicap of Epilepsy (SHE) in Brazilian patients with epilepsy

Monteiro

Osório

Alexandre

et al. 2012

Epilepsy & Behavior

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“…In the initial review there were no Class I reports. One would have met criteria for Class II 14 and the remainder for Class III, except that none had a masked outcome assessment; therefore, all were Class IV. Papers were further evaluated according to a rating scale (see the Appendix on the Neurology Web site; go to www.neurology.org) designed to eliminate papers with less reliable data, and to permit stratification of the remainder at a later date, if desired, according to criteria that might influence the results of the evaluation.…”

Section: Clinical Question Statementmentioning

confidence: 99%

Practice parameter: Temporal lobe and localized neocortical resections for epilepsy

Engel

Wiebe²,

French³

et al. 2003

Neurology

785

291

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Abstract-Objectives/Methods: To examine evidence for effectiveness of anteromesial temporal lobe and localized neocortical resections for disabling complex partial seizures by systematic review and analysis of the literature since 1990. Results: One intention-to-treat Class I randomized, controlled trial of surgery for mesial temporal lobe epilepsy found that 58% of patients randomized to be evaluated for surgical therapy (64% of those who received surgery) were free of disabling seizures and 10 to 15% were unimproved at the end of 1 year, compared with 8% free of disabling seizures in the group randomized to continued medical therapy. There was a significant improvement in quantitative quality-of-life scores and a trend toward better social function at the end of 1 year for patients in the surgical group, no surgical mortality, and infrequent morbidity. Twenty-four Class IV series of temporal lobe resections yielded essentially identical results. There are similar Class IV results for localized neocortical resections; no Class I or II studies are available. Conclusions: A single Class I study and 24 Class IV studies indicate that the benefits of anteromesial temporal lobe resection for disabling complex partial seizures is greater than continued treatment with antiepileptic drugs, and the risks are at least comparable. For patients who are compromised by such seizures, referral to an epilepsy surgery center should be strongly considered. Further studies are needed to determine if neocortical seizures benefit from surgery, and whether early surgical intervention should be the treatment of choice for certain surgically remediable epileptic syndromes.

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“…Therefore several measures were developed to complement the traditional outcome evaluations and to assess other dimensions of HRQOL (1-3), which include the ability to drive, freedom from bothersome medication side effects, participation in social activities, independence, successful employment, seizure unpredictability, or social embarrassment (4,5). In patients with epilepsy, HRQOL measures improve with attaining seizure freedom, independent of the treatment type used to achieve the seizure freedom (6)(7)(8)(9)(10)(11)(12). The data regarding HRQOL in psychogenic nonepileptic seizures (PNESs) are limited (13,14).…”

mentioning

confidence: 99%

Quality of Life in Psychogenic Nonepileptic Seizures

Szaflarski¹,

Hughes²,

et al. 2003

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Summary:Purpose: Psychogenic nonepileptic seizures (PNESs) are events that alter or seem to alter the neurologic function and, in their appearance, resemble epileptic seizures (ESs). In patients with ESs the psychological and medical aspects of epilepsy greatly influence the health-related quality of life (HRQOL). The relation between these factors and PNESs is not well established. In this study, we compared HRQOL in patients with PNESs with that of patients with ESs.Methods: We evaluated 105 patients admitted to the Epilepsy Monitoring Unit of University Hospital between January 20, 2001, and January 20, 2002. Only patients with the definite diagnosis of ESs or PNESs were analyzed (n ‫ס‬ 85). Patients completed an epilepsy-specific quality-of-life instrument (QOLIE-89), the Profile of Mood States (POMS), and Adverse Events Profile (AEP). We used t tests and regression analyses to contrast HRQOL in PNESs and ESs and to elucidate the main factors associated with HRQOL in patients with PNESs.Results: In our sample, 45 patients had PNESs, and 40 hadESs. The overall HRQOL and scores on 13 of 19 QOLIE-89 subscales were significantly lower (i.e., worse) in PNES than in ES patients. AEP and scores on five of six POMS subscales also were worse in PNES patients than in ES patients. PNES versus ES diagnosis, POMS depression/dejection, and AEP were significant predictors of HRQOL, jointly explaining 65% variation in HRQOL. The lower HRQOL in PNESs versus ESs was in part explained by depression and AEP.Conclusions: Patients with PNESs have a lower HRQOL and worse mood problems than do patients with ESs. This disadvantage is primarily due to depression and medication side effects, although these factors influence QOL in much the same way in PNES and ES patients. These baseline HRQOL data on patients with PNESs can be used to evaluate the effects of treatment in this patient population.

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Outcomes in 248 patients who had diagnostic evaluations for epilepsy surgery

Cited by 178 publications

References 19 publications

Validation of the Subjective Handicap of Epilepsy (SHE) in Brazilian patients with epilepsy

Validation of the Subjective Handicap of Epilepsy (SHE) in Brazilian patients with epilepsy

Practice parameter: Temporal lobe and localized neocortical resections for epilepsy

Quality of Life in Psychogenic Nonepileptic Seizures

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