Quality of life and epilepsy surgery in childhood and adolescence

Gagliardi, I C; Guimarães, Catarina Abraão; Souza, Elisabete Abib Pedroso de; Schmutzler, Kátia M.R.; Guerreiro, Marilisa M.

doi:10.1590/s0004-282x2011000100006

Cited by 15 publications

(4 citation statements)

References 27 publications

(66 reference statements)

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“…Seizure‐free patients had significantly lower (better) internalizing behavior scores and higher (better) scores on IQ and HRQOL subscales including overall HRQOL, QOL item, social functioning, health perception, and seizure worry. These results mirror studies that have restricted minimum follow‐up to 2 years and studies that collectively assess patients after short‐ and long‐term follow‐up, finding that seizure freedom is associated with improved HRQOL. Similar results were found by Baca et al., who examined nonsurgical patients 9 years after epilepsy diagnosis.…”

Section: Discussionsupporting

confidence: 72%

Predictors of long‐term quality of life after pediatric epilepsy surgery

Puka

Smith

2015

Epilepsia

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SUMMARYObjective: This study examined the influence of seizures, antiepileptic drugs (AEDs), intelligence quotient (IQ), and symptoms of depression and anxiety on health-related quality of life (HRQOL) 4-11 years after pediatric epilepsy surgery. Methods: Participants were 109 patients with childhood-onset intractable epilepsy; 71 had undergone surgery on average 6.9 years before this study. Patients and their parents completed questionnaires assessing HRQOL and internalizing behavior, a measure of depression and anxiety symptoms. Results: Similar rates of recent seizure freedom were found for surgical and nonsurgical patients, although surgical patients had achieved seizure freedom sooner and with fewer AEDs. Few differences were found between surgical and nonsurgical patients. Differences emerged when comparing patients with continued seizures and those who had been seizure-free in the 12 months preceding the study. Almost all HRQOL ratings were enhanced in seizure-free patients. Internalizing behavior (anxiety/depression) mediated the relationship between seizure freedom and better HRQOL, where seizure freedom led to better ratings of anxiety/depression, which in turn led to better ratings of HRQOL. AED use was found to be associated with social functioning, medication effects, and seizure worry. IQ and duration of follow-up were not found to independently influence HRQOL. Significance: The findings highlight the integral role of depression and anxiety symptoms in determining HRQOL; seizure control seems to play a secondary role. This study expands this relationship to individuals who have a history of intractable childhood epilepsy. The findings highlight the importance of managing depression and anxiety in improving the HRQOL and reducing seizure burden on patients.

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Section: Discussionsupporting

confidence: 72%

Predictors of long‐term quality of life after pediatric epilepsy surgery

Puka

Smith

2015

Epilepsia

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“…Figure details how we identified 54 articles for inclusion within the review . Another 62 articles were included in the addendum . Agreement between the two reviewers on study inclusion or exclusion was calculated using Cohen's kappa statistic ( κ =0.96 [standard error=0.014]).…”

Section: Resultsmentioning

confidence: 99%

Life quality and health in adolescents and emerging adults with epilepsy during the years of transition: a scoping review

Thomson

Fayed

Sedarous

et al. 2013

Develop Med Child Neuro

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ABBREVIATIONS ICFInternational Classification of Functioning, Disability and Health QOL Quality of life AIMS The aims of this study were to (1) search the literature in order to identify the challenges facing adolescents and emerging adults with epilepsy; and (2) categorize these issues within both the framework of the International Classification of Functioning, Disability and Health (ICF) and an empirical model of quality of life (QOL) in childhood epilepsy.METHOD We systematically searched PsycINFO, Ovid MEDLINE and Web of Science for studies reporting on QOL and health identified in people with epilepsy aged 12 to 29 years. Studies were limited to those that were published in the last 20 years in English, presenting the patient perspective. Data were extracted and charted using a descriptive analytical method. Identified issues were classified according to the ICF and QOL frameworks.RESULTS Fifty four studies were identified. Another 62 studies with potentially useful information were included as an addendum. The studies highlight a range of psychosocial issues emphasizing peer acceptance, social isolation, and feelings of anxiety, fear, and sadness.INTERPRETATION The ICF and QOL constructs represent useful starting points in the analytical classification of the potential challenges faced by adolescents with epilepsy. Progress is needed on fully classifying issues not included under these frameworks. We propose to expand these frameworks to include comorbidities, impending medical interventions, and concerns for future education, employment, marriage, dignity, and autonomy.Epilepsy can have a profound effect on health and quality of life (QOL). It may hinder the development of independence, social functioning, peer relationships, and self-esteem, all of which are particularly important during adolescence. [1][2][3] In this developmental period, individuals form a sense of identity and autonomy, relying heavily on peer relationships. 4 Adolescents begin to make educational, career, and intimate relationship decisions. 4 The challenges facing young people with epilepsy persist into adulthood; for example, marriage and employment rates are reported to be lower in adults with childhood-onset epilepsy than in the rest of the population. 5 Biomedical diagnosis alone does not accurately predict health outcomes, the level of care required by patients, work performance, or social integration. 6 To better examine these outcomes, life and health challenges must be identified, analysed, and categorized. Recognition and conceptual classification of these issues may provide insight into the life-course trajectory of individuals with epilepsy and help mitigate long-term outcomes. It is of critical importance to examine these issues from the patient perspective, as the views of patients, parents, and clinicians may differ regarding the value placed on health outcomes and QOL. 7,8 In this review we have used the following operational definitions for the key concepts. Health status is defined as a snapshot of functioning, at ...

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“…Table 4 shows neurostimulative techniques like VNS [57,86,120,138,151,157,173] and deep brain stimulation [73], which reflected that the majority of subjects had more than 50% seizure reduction with follow-ups ranging between one to four years. Table 5 showed that the indicators of QOL improved after surgery [37,47,50,59,93,98,101,122,126,134,159,160,165,175,177], except in one study [62]. Table 6 reports on the cost of epilepsy surgery [66,70,71,114,117,144,147,164,168,171,172] and VNS [138], the cost of epilepsy surgery as at 2014 ranges between US$500 in Iran to approximately US$8,000 in China.…”

Section: Tunisian Epilepsy Surgery Program At the Charles Nicolle Hosmentioning

confidence: 99%

Epilepsy surgery in low- and middle-income countries: A scoping review

Watila

Xiao

Keezer

et al. 2019

Epilepsy & Behavior

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Background: Epilepsy surgery is an important treatment option for people with drug resistant epilepsy. Although surgical procedures are under-utilized worldwide, it is far worse in Low-and Middle-Income Countries (LMIC) and it is less clear to what extent people with drug resistant epilepsy receive such treatment at all. Here we review the existing evidence for the availability and outcome of epilepsy surgery in LMIC, and discuss some challenges and priority. Methods: We used the six stage methodological framework developed by Arskey and O'Malley as a guide. We searched PubMed, Embase, Global Health Archives, Index Medicus for South East Asia Region (IMSEAR), Index Medicus for Eastern Mediterranean Region (IMEMR), Latin American & Caribbean Health Sciences Literature (LILACS), African Journal Online (AJOL), and African Index Medicus (AIM) to identify the relevant literature. Results: We retrieved 148 articles on epilepsy surgery from 31 countries representing 22% of the 143 LMIC. Epilepsy surgery appears established in some of these centers in Asia and Latin America, while some are in their embryonic stage reporting procedures in a small cohort performed mostly by motivated neurosurgeons. The commonest surgical procedure reported was temporal lobectomies. The post-operative seizure-free rates and quality of life are comparable to those in the high-income countries (HIC). Some models have shown that epilepsy surgery can be performed within a resourcelimited setting through collaboration with international partners and through the use of information and communication technology. The cost of surgery is a fraction of what is available in HIC. Conclusion: This review has demonstrated the availability of epilepsy surgery in few LMIC. The information available is inadequate to make any reasonable conclusion of its existence as routine practice. Collaborations with international partners can provide an opportunity to bring high-quality academic training and technological transfer directly to surgeons working in these regions and should be encouraged.

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Quality of life and epilepsy surgery in childhood and adolescence

Cited by 15 publications

References 27 publications

Predictors of long‐term quality of life after pediatric epilepsy surgery

Predictors of long‐term quality of life after pediatric epilepsy surgery

Life quality and health in adolescents and emerging adults with epilepsy during the years of transition: a scoping review

Epilepsy surgery in low- and middle-income countries: A scoping review

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