Seizure freedom improves health‐related quality of life after epilepsy surgery in children

Jain, Puneet; Smith, Mary Lou; Speechley, Kathy N.; Ferro, Mark A.; Connolly, Mary; RamachandranNair, Rajesh; Almubarak, Salah; Andrade, Andrea; Widjaja, Elysa

doi:10.1111/dmcn.14390

Cited by 24 publications

(29 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with our previous research examining child HRQOL, 36 which found that seizure freedom mediated the relationship between treatment and HRQOL at 1-year follow-up; children who had surgery were more likely to achieve seizure freedom, which in turn was associated with improved HRQOL. 36 These findings are also consistent with our prior study that showed seizure freedom, rather than treatment type, was associated with better emotional functioning, one dimension of HRQOL. 37 This multisite study employed a longitudinal design with children followed up for 1 year and utilized data that were prospectively collected.…”

Section: Discussionsupporting

confidence: 91%

Family resources moderate the relationship between seizure control and health‐related quality of life in children with drug‐resistant epilepsy

2020

Self Cite

View full text Add to dashboard Cite

Objective: Pediatric drug-resistant epilepsy (DRE) is associated with poor health-related quality of life (HRQOL). Achieving seizure control, however, does not improve HRQOL in all children. This study sought to evaluate whether (1) baseline caregiver and family factors are associated with child HRQOL at 1-year follow-up over and above epilepsy characteristics, treatment, and seizure outcome; and (2) baseline family factors moderate the association between seizure outcome and child HRQOL at 1-year follow-up. Methods: This multicenter longitudinal cohort study recruited 152 children with DRE who were being evaluated for surgical candidacy. Child HRQOL was rated by caregivers using the Quality of Life in Childhood Epilepsy Questionnaire at baseline and 1-year follow-up. Additional data collected at baseline included child epilepsy characteristics, caregiver demographics, caregiver mood, and family environment. Results: Seizure freedom was achieved in 68% and 28% of patients 1 year after surgery and medical treatment, respectively. Caregiver and family factors were not associated with higher child HRQOL at follow-up after accounting for epilepsy characteristics, treatment, seizure outcome, and baseline child HRQOL, F 11, 131 = 1.34,

show abstract

Section: Discussionsupporting

confidence: 91%

Family resources moderate the relationship between seizure control and health‐related quality of life in children with drug‐resistant epilepsy

2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Steinbok et al in a multicenter study of 116 infants (up to 3 years of age) report a developmental improvement in most children following surgery 25 . Others state stabilization of developmental impairment following surgery, 32 and that postsurgical developmental status positively correlated with preoperative developmental status 15 . Dunkley et al speculated that cognitive injury occurs early in the epileptic course, and is often irreversible 27 .…”

Section: Discussionmentioning

confidence: 99%

Epilepsy surgery in infants up to 3 months of age: Safety, feasibility, and outcomes: A multicenter, multinational study

et al. 2021

View full text Add to dashboard Cite

Summary Objective Drug‐resistant epilepsy (DRE) during the first few months of life is challenging and necessitates aggressive treatment, including surgery. Because the most common causes of DRE in infancy are related to extensive developmental anomalies, surgery often entails extensive tissue resections or disconnection. The literature on “ultra‐early” epilepsy surgery is sparse, with limited data concerning efficacy controlling the seizures, and safety. The current study's goal is to review the safety and efficacy of ultra‐early epilepsy surgery performed before the age of 3 months. Methods To achieve a large sample size and external validity, a multinational, multicenter retrospective study was performed, focusing on epilepsy surgery for infants younger than 3 months of age. Collected data included epilepsy characteristics, surgical details, epilepsy outcome, and complications. Results Sixty‐four patients underwent 69 surgeries before the age of 3 months. The most common pathologies were cortical dysplasia (28), hemimegalencephaly (17), and tubers (5). The most common procedures were hemispheric surgeries (48 procedures). Two cases were intentionally staged, and one was unexpectedly aborted. Nearly all patients received blood products. There were no perioperative deaths and no major unexpected permanent morbidities. Twenty‐five percent of patients undergoing hemispheric surgeries developed hydrocephalus. Excellent epilepsy outcome (International League Against Epilepsy [ILAE] grade I) was achieved in 66% of cases over a median follow‐up of 41 months (19–104 interquartile range [IQR]). The number of antiseizure medications was significantly reduced (median 2 drugs, 1–3 IQR, p < .0001). Outcome was not significantly associated with the type of surgery (hemispheric or more limited resections). Significance Epilepsy surgery during the first few months of life is associated with excellent seizure control, and when performed by highly experienced teams, is not associated with more permanent morbidity than surgery in older infants. Thus surgical treatment should not be postponed to treat DRE in very young infants based on their age.

show abstract

“…100 Moreover, the benefit on quality of life, cognitive evolution, particularly for children, and psychiatric comorbidities is positive. [108][109][110] This global benefit is also stated in more specific populations, including children with autism spectrum disorders 111 or older adults (more than 60 years). 112 It should be emphasized that lesion on MRI is not a prerequisite for epilepsy surgery.…”

Section: Epilepsy Surgerymentioning

confidence: 96%

Clinical Management of Drug Resistant Epilepsy: A Review on Current Strategies

Guéry

Rheims

2021

NDT

View full text Add to dashboard Cite

Drug resistant epilepsy (DRE) is defined as the persistence of seizures despite at least two syndrome-adapted antiseizure drugs (ASD) used at efficacious daily dose. Despite the increasing number of available ASD, about a third of patients with epilepsy still suffer from drug resistance. Several factors are associated with the risk of evolution to DRE in patients with newly diagnosed epilepsy, including epilepsy onset in the infancy, intellectual disability, symptomatic epilepsy and abnormal neurological exam. Pharmacological management often consists in ASD polytherapy. However, because quality of life is driven by several factors in patients with DRE, including the tolerability of the treatment, ASD management should try to optimize efficacy while anticipating the risks of drug-related adverse events. All patients with DRE should be evaluated at least once in a tertiary epilepsy center, especially to discuss eligibility for non-pharmacological therapies. This is of paramount importance in patients with drug resistant focal epilepsy in whom epilepsy surgery can result in long-term seizure freedom. Vagus nerve stimulation, deep brain stimulation or cortical stimulation can also improve seizure control. Lastly, considering the effect of DRE on psychologic status and social integration, comprehensive care adaptations are always needed in order to improve patients' quality of life.

show abstract

Seizure freedom improves health‐related quality of life after epilepsy surgery in children

Cited by 24 publications

References 49 publications

Family resources moderate the relationship between seizure control and health‐related quality of life in children with drug‐resistant epilepsy

Family resources moderate the relationship between seizure control and health‐related quality of life in children with drug‐resistant epilepsy

Epilepsy surgery in infants up to 3 months of age: Safety, feasibility, and outcomes: A multicenter, multinational study

Clinical Management of Drug Resistant Epilepsy: A Review on Current Strategies

Contact Info

Product

Resources

About